The author describes 4 cases of thoracic back pain. All 4 had significant night pain, and 3 of the 4 presented with an upper motor neuron lesion of the lower limbs subsequestly diagnosed as a primary vertebral tumor. All lesions were well demonstrated on CT examination and were proved to be chordoma, lymphoma, solitary plasmacytoma or aneurysmal bone cyst. Awareness of primary thoracic tumours is important, as early recognition may prevent irreversible damage to the cord.
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