Symptomatic Calcifying Pseudotumor of the Thoracic Spine That Resolved with the Indomethacin Treatment: a Case Report

Study Design: Case report.

Objective: To report a rare case of calcifying pseudotumor of the thoracic spine that resolved completely with Indomethacin treatment.

Summary Of Background Data: A 48-year-old male patient presented with a complaint of left T9 radiculopathy. Computed tomography scan and magnetic resonance images showed a calcifying pseudotumor of the thoracic spine. The nature of this disease remains unknown. This lesion behaves as a tumor-like lesion that is probably inflammatory in nature with a bone-forming potential.

Methods: The patient was treated conservatively with Indomethacin 25 mg 3 times daily for 8 weeks. The lesion was monitored with computed tomography and magnetic resonance imaging at 8 weeks and at 16 weeks after initiation of treatment.

Results: The patient had radicular pain for 8 weeks and sleep disturbance for 6 weeks prior to treatment. After he started taking Indomethacin 25 mg 3 times daily, the radicular pain resolved on the third day of Indomethacin treatment. The size of the mass reduced significantly at eighth week follow-up and resolved completely at 16 weeks of follow-up.

Conclusion: Calcifying pseudotumor of spine should be treated with a trial of Indomethacin before surgical option is offered, unless the patient has a significant progressive neurological deficit that requires urgent surgical intervention.