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Desmoplastic Fibroma of the Cervical Spine: Case Report and Review of the Literature

Zhang, Feng, MD; Ni, Bin, MD; Zhao, Liangyu, MD; Chen, Huajiang, MD; Li, Songkai, MD; Zhou, Fengjin, MD; Yang, Jian, MD; Tsai, Nicholas, MD

doi: 10.1097/BRS.0b013e3181cf7073
Case Reports
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Study Design. A case report and literature review are presented.

Objective. To present a rare case of desmoplastic fibroma (DF) in the cervical spine and discuss the diagnosis and treatment of this disorder.

Summary of Background Data. DF is an extremely rare primary tumor of bone, especially in cervical spine. It is a benign but locally aggressive tumor of the connective tissue. It has a predilection for the mandible and the metadiaphyses of long bones. It has a propensity for local recurrence, especially after intralesional resection.

Methods. We report on a 70-year-old woman with a DF of the fourth and fifth cervical vertebrae. The patient complained of progressive neck pain and limitation of activity. After radiologic evaluation, a mass lesion was found on the fourth and fifth cervical vertebral bodies. A 2-level corpectomy with wide marginal resection of the tumor was performed through the anterior approach, and the histopathologic examination yielded the diagnosis of DF. Reconstruction was achieved with a long titanium mesh and locking plate with autologous iliac crest bone graft.

Results. After surgery, pain was completely relieved, and neurologic function was normal. The postoperative course was uneventful, and the patient has been well without recurrence for 35 months of follow-up evaluation.

Conclusion. Patients with DF of the cervical spine may present with the arm and neck pain mimicking cervical disc disease. High index of suspicion by the clinicians must be practiced to make the appropriate diagnosis, and histologic confirmation of the diagnosis is essential. Surgical resection with wide margins is the preferred treatment.

Desmoplastic fibroma is a rare primary tumor of bone, especially in cervical spine. Patients with desmoplastic fibroma of cervical spine may masquerade as cervical disc disease. High index of suspicion must be practiced to make the appropriate diagnosis, and histologic confirmation of the diagnosis is essential. Surgical resection with wide margins is the preferred treatment.

From the Department of Orthopedic Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, People's Republic of China.

Acknowledgment date: October 7, 2009. Revision date: December 3, 2009. Acceptance date: December 9, 2009.

The manuscript submitted does not contain information about medical device(s)/drug(s).

No funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

Address correspondence and reprint requests to Huajiang Chen, MD, Department of Orthopedic Surgery, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai 200003, People's Republic of China; E-mail: dr.huajiang@gmail.com

© 2010 Lippincott Williams & Wilkins, Inc.