Search

Background: Primary osteosarcoma of craniovertebral junction is extremely rare and reports in paediatric patients are limited. The symptoms are subtle and mostly underestimated.Case presentation.We present an unusual case of a 11-years old girl affected by an extensive and metastatic osteosarcoma of the atlas presented with cervicalgia and right torticollis refractory to medical treatment. The patient underwent open biopsy confirming the malignant histology. Conclusions: Cervicalgia with or without a torticollis refractory to medical treatment, in absence of history of fell or trauma, is highly suspicious and should be considered as a warning sign for a severe pathology and it should not be neglected.

Calvaria defects in children present a reconstructive challenge. When autogenous bone is not available, synthetic materials can be used; however, they present many drawbacks limiting their use in infants. Children, especially under the age of two, represent an incomparable limitation and they are infrequently reported in literature. The reconstructive strategies presented in the last decades are different without a clear consensus about the best procedure and material for a specific range of age. We report our experience with resorbable mesh cranioplasty using a polylactic acid / polyglycolic acid resorbable mesh plate with bone matrix in a 3-month old child who previously underwent decompressive craniectomy. This reconstructive strategy failed, and the patient was scheduled for a second procedure. After the case presentation, the literature is reviewed and discussed focusing on infants and young children. Keywords: Craniectomy, Cranioplasty, Infant, Resorbable mesh