Pain and osteolysis of the thoracic spine--a case of a rare monostotic fibrous dysplasia manifestation.

We describe a case of a young farmer from Central Macedonia, Greece suffering of a mild back pain more than one year. His medical history included hypercholesterolaemia (IIa type) and two episodes of spontaneous pneumothorax of unknown origin two and three years ago respectively. A full imaging survey revealed a single osteolytic lesion at the seventh thoracic vertebra. A CT guided needle biopsy was performed. Diagnosis based on clinical, imaging and histological findings was monostotic fibrous dysplasia of the thoracic spine. We discuss the clinical features and treatment of this non neoplastic condition which may simulate bone osteolytic tumor. Furthermore a possible correlation of concomitant conditions existing in our patient such as the metabolic disorder of hypercholesterolaemia and especially the history of spontaneous pneumothorax episodes with fibrous dysplasia within the spectrum of connective tissue disorder is discussed.