t11 vertebrate replaced by fatty tissue

[stressed65]

please help!  4-5 days ago, my 18yo daughter started having bilateral pain in both legs, down backs of thighs somewhat like sciatica, however, when she stood, the pain went to her calves, to the point of her almost collapsing. Also every night charlie horses. Pain rapidly became worse as each day went by.  NO TRAUMA, NO FALLS, NO TWISTS, NO SPORTS> normal lumbar xray, however today MRI SPINE: "complete fatty tissue replacement of the t11 vertebral body of indeterminate etiology...increased t1 and proton density signal and decreased signal on fat supressed t2 and inversion recoveruy images.There is no enhancement. There is a tiny area of what appears to be normal marrow at the left psoterior inferior end platein the lefter inferior aspect of the left pedicle as seen on sagittal series.....The fatty replacement involves the posterior elements as well as nearly the entire vertebral body. No expansion of the vertebral body. cortices are intact. no retropulsion...."  She has NEVER been on steroids.  Tomorrow the thoracic spine will have mri with and without contrast as well.  PLEASE PLEASE ADVISE, AS NO ONE HAS ANY IDEAS OF ETIOLOGY, AND THE DOCTORS HAVE STATED THEY'VE NEVER SEEN THIS BEFORE.

[DrNoopurMD]

Hi,

Thanks for the update. I can imagine what you must be going through.
Spinal hemagiomas are benign tumors of the spine and are most commonly seen in the thoracic and lumbar spine. The tumor usually affects the vertebral body and has very few symptoms. However it can produce symptoms of nerve compression like in your daughter’s case.
The treatment is mainly embolization or blockade of blood flow to the tumor, surgical excision or radioatherapy.
The treatment may require expertise of many doctors including an orthopedic specialist neurologist, spinal surgeon and an oncologist.
It is good that you will be consulting an orthopedic specialist soon. Keep us posted.

[stressed65]

thanks for your reply.  yes, those criteria are not the case here. However, todays mri of the thoracic (1st was lumbar) read by a differrent doctor, read as : "Impression: most likely suggrestive of hemangioma" . Initially the radiologist told the pediatrician it was a suspected lipoma, now hemangioma.  WE ARE SPINNING!!  My daughter is on percocet, sometimes q2-3 hours; plus moist heat.  we are in the process of making an out of state appt with the Chair of Orthopeadics at CHOP. Do you suggest Neuro or Ortho????? 2 separate mri's, 24 hours apart, 2 different radiologists, 2 different diagnosis!!!!! My ONLY daughter!

[DrNoopurMD]

Hi,

This type of MRI findings of vertebral body replacement by fatty tissues has been clinically seen in patients with history of compression fractures of vertebras or in patients who have received radiotherapy for cancer.
If these are not the likely causes in your daughter’ case then it is very difficult to say what the underlying cause is.
You need to consult a neurologist with a very good experience in this field. Let us know if you have more questions.

Thanks