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Chronic suppurative inflammatory cyst in the sacrum
1Department of Orthopaedic Surgery, School of Medicine, Jeju National University, Jeju Self Governing Province, Jeju, Korea.
Summary
An atypical inflammatory sacral cyst caused severe symptoms in a 77-year-old woman. Surgical removal of the cyst led to neurological improvement, highlighting the need for accurate diagnosis before interventions.
Area of Science:
- Neurology
- Radiology
- Pathology
Background:
- Sacral bone remodeling and intervertebral foramina dilatation are often linked to Tarlov's cysts.
- However, slow-growing lesions can also cause these changes.
- Atypical inflammatory sacral cysts present a diagnostic challenge.
Purpose of the Study:
- To report a case of an atypical inflammatory sacral cyst.
- To discuss potential causes and diagnostic considerations.
- To emphasize the importance of pre-procedural identification of sacral cysts.
Main Methods:
- Case report of a 77-year-old woman with back pain and neurological deficits.
- Plain roentgenogram, CT, and MRI for imaging.
- Surgical laminectomy and histological analysis of the cyst.
Main Results:
- Imaging revealed spinal canal expansion and sacral scalloping.
- MRI showed a septated cyst with peripheral enhancement.
- Histology confirmed an inflammatory cyst with neutrophils and lymphocytes, leading to symptom improvement post-surgery.
Conclusions:
- Atypical inflammatory sacral cysts can mimic other lesions.
- Accurate diagnosis is crucial to avoid complications from procedures like acupuncture or epidural injections.
- Prompt surgical intervention can resolve neurological symptoms.
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