Revision 11 for 'Vertebral body mass'

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Vertebral body mass

The differential diagnosis for a vertebral body mass is broad and may range from a completely benign, sclerotic enostosis (bone island) to a malignant primary bone tumor.

Classification

Broadly, these lesions can be separated into

  • non-neoplastic lesions
  • primary bone tumors
  • secondary metastatic disease
Non-neoplastic lesions
Primary bone tumors

Primary bone tumors of the spine are much less common than secondary metastatic disease:

  • chordoma
    • more common in sacrum (50%) and clivus (35%) then cervicothoracic vertebral column (15%)
Secondary metastatic disease

Vertebral metastases are significantly more common than primary bone tumors, especially in an older patient or one with known primary disease elsewhere.

Assessment of whether the bone lesions are sclerotic or lytic may help to narrow the differential diagnosis of primary disease if it is unknown.

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