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Figure 1: A 65-year-old male presented with low mid back pain. Various investigations included X-ray (a) showing no specific finding, CT scan spine (b and d) showing an osteolytic lesion at D10 involving the right vertebral body and the posterior elements. MRI (c) showed a hypointense lesion involving the right part of the D10 vertebral body, pedicle, adjacent rib, and laminae. Whole-body PET showed hyper-metabolic focus the D10 vertebra and medial part of the spine of the left scapula (f and g). CT scan confirmed a lesion at the medial part of the spine of the left scapula. Patient underwent “en-bloc” excision of the right hemi body of the D 10 vertebra and posterior elements with circumferential fusion (expandable cage with single level pedicle screw fixation)

Figure 1: A 65-year-old male presented with low mid back pain. Various investigations included X-ray (a) showing no specific finding, CT scan spine (b and d) showing an osteolytic lesion at D10 involving the right vertebral body and the posterior elements. MRI (c) showed a hypointense lesion involving the right part of the D10 vertebral body, pedicle, adjacent rib, and laminae. Whole-body PET showed hyper-metabolic focus the D10 vertebra and medial part of the spine of the left scapula (f and g). CT scan confirmed a lesion at the medial part of the spine of the left scapula. Patient underwent “en-bloc” excision of the right hemi body of the D 10 vertebra and posterior elements with circumferential fusion (expandable cage with single level pedicle screw fixation)