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Abdominal pain secondary to a sacral perineural cyst
Curtis W Slipman1, Atul L Bhat, Sarjoo M Bhagia
1Penn Spine Center Research Group, Department of Rehabilitation Medicine, Hospital of University of Pennsylvania, Philadelphia, PA 19104, USA. slipman@mail.med.upenn.edu
Background Context:
Perineural cysts are commonly found in the sacral region and are incidently discovered on imaging studies performed for the evaluation of low back and/or leg pain.
Purpose:
To report on a patient presenting with abdominal pain secondary to a large sacral perineural cyst.
Study Design/Setting:
Case report. METHODS/PATIENT SAMPLE: A 47-year-old woman was referred to a specialized multidisciplinary spine center with complaints of left lower quadrant abdominal pain and left leg pain. Of significant note was the presence of constipation and urinary frequency over the preceding 8 months. Physical examination was normal. Magnetic resonance imaging of the lumbosacral spine revealed large perineural cysts eroding the sacrum and extending to the pelvis. The presence of abdominal symptoms prompted a neurosurgical consultation. However, after considering the possible risks associated with the surgical procedure, the patient opted to follow the nonsurgical route.
Result And Conclusions:
Although commonly visualized, sacral perineural cysts are rarely symptomatic. When symptomatic, it may be secondary to its size and location. Presence of abdominal pain in a patient with back and/or leg pain should prompt the evaluation of the lumbosacral spine.