Vertebral metastasis (hepatocellular carcinoma)
Severe mid back ache
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Collapse of D8 vertebral body with convex posterior verterbal margin retropulsed and impinging on ventral thecal sac, compressing dorsal cord. Signal change also seen in left 8th rib head. T1 hypointense, T2 and STIR heterogeneously hyperintense with associated left paravertebral soft tissue component. No other dorsal vertebral lesions.
2 case question available
Collapse of the vertebral body needs to be distinguished from benign degenerative collapse. The concave posterior margin of the vertebra as it retropulses into the canal and the presence of associated soft tissue component favors pathological fracture. In a known case of hepatocellular carcinoma, findings are consistent with secondary deposit.