Osteochondroma Arising from the Transverse Process of the Lower Cervical Spine in an Elderly Patient

Osteochondroma rarely occurs in the lower cervical spine in elderly patients, because it usually develops during skeletal growth and because of the limited mobility and lower stress in the lower cervical spine.

A 63-year-old man complained of 3-month history of neck pain and a hard, palpable mass in the lower cervical spine. Plain radiography, computed tomography (CT) scan, and magnetic resonance imaging (MRI) revealed a bony mass arising from the left C5 transverse process with a medullary continuation and calcification and soft tissue displacement at the C4-C6 level. After the operation, the biopsy finding was consistent with osteochondroma, without malignant degeneration. We performed en bloc resection of the tumor, including the cartilaginous cap. The patient's symptoms improved after resection of the osteochondroma and demonstrated no recurrence of tumor at a 1-year follow-up.

This patient had a rare involvement of the transverse process without neurologic symptoms. Multiple imaging modalities, including plain radiography, CT, and MRI, play important roles in the diagnosis of osteochondroma. Complete surgical excision, including the cartilaginous cap, achieved a satisfactory surgical outcome and prevented possible recurrence.