A Rare Cause of Infantile Scoliosis in a 9-Month-Old Child

A mother brought her 9-month-old boy to our orthopedic clinic after curvature of the spine had been detected at the routine U-5 pediatric check-up. Clinical examination and plain radiography revealed thoracolumbar scoliosis (Figure a). The spinal curvature was in the frontal plane, which is extremely rare at this age. Suspicion was aroused by the fact that radiographs in this otherwise healthy patient showed no rotation component in the spinal column, which would normally be expected in idiopathic infantile scoliosis. We therefore requested magnetic resonance imaging of the whole spine. This revealed a possibly malignant left-sided paravertebral mass in the erector spinae muscles at the level of the thoracic spine, leading to displacement of the spinal column and thus to secondary scoliosis (Figure b). This mass was not palpable on clinical examination. Histological analysis showed hemangioepithelioma: an extremely rare sarcoma of low malignancy. The patient is currently being treated with the mTOR inhibitor sirolimus.

Figure

Radiograph / MRT

Dr. Maximilian Weber, Dr. med. habil. Stavros Oikonomidis, Prof. Dr. Peer Eysel, Universitätsklinikum Köln, Klinik und Poliklinik für Orthopädie, Unfallchirurgie und Plastisch-Ästhetische Chirurgie, [e-mail]

Conflict of interest statement: The authors declare that no conflict of interest exists.

Translated from the original German by David Roseveare.

Cite this as: Weber M, Oikonomidis S, Eysel P: A rare cause of infantile scoliosis in a 9-month-old child. Dtsch Arztebl Int 2024; 121: 173. DOI: 10.3238/arztebl.m2022.0401