Spinal Enchondromas in the Cervical Spine: Rarity, Recurrence and the Importance of Long-Term Surveillance.

Introduction: Chondromas are benign cartilaginous tumors classified into periosteal chondromas and enchondromas. While periosteal chondromas grow on the bone surface, enchondromas develop within the medullary cavity. Enchondromas constitute 4-8% of all bone tumors, with spinal enchondromas being exceptionally rare, particularly in the cervical region. Despite their benign nature, spinal enchondromas can cause significant clinical symptoms and have the potential for recurrence or malignant transformation.

Case report: A 14-year-old female presented with a swelling on the posterior aspect of her neck, accompanied by dull, aching pain radiating into the right upper limb, and muscle weakness assessed at IV/V. Imaging studies, including computed tomography (CT) and magnetic resonance imaging, revealed a lobulated lesion in the right lamina of the C4 vertebra extending to C5, causing spinal cord and nerve root indentation. The patient underwent a C4-C5 laminectomy with complete tumor excision. Histopathological examination confirmed the diagnosis of enchondroma.

Follow-up and outcomes: At 6 months, the patient experienced complete resolution of pain and significant improvement in neurological symptoms. Follow-up CT scans at 3 years and at 10 years did not exhibit any recurrence, and the patient remained symptom-free throughout the follow-up period.

Conclusion: This case highlights the successful long-term outcome following the surgical resection of a cervical spine enchondroma, demonstrating that aggressive surgical intervention can lead to sustained symptom-free outcomes. The 10-year follow-up provides valuable insight into the long-term prognosis of cervical spine enchondromas, emphasizing the importance of early and complete surgical resection along with extended surveillance.