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An Orthotopic Sciatic Nerve Xenograft for Neurofibromatosis Type 1 Neurofibromas
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Granulocytic sarcoma: a rare cause of sciatica.

Epaminondas Markos Valsamis1, Thomas Edward Glover2

  • 1Department of Trauma and Orthopaedics, Hinchingbrooke Health Care NHS Trust, Huntingdon, Cambridgeshire, UK.

BMJ Case Reports
|February 17, 2017
PubMed
Summary

A man with sciatica experienced worsening pain due to a granulocytic sarcoma, not disc herniation. This case highlights that disc prolapse can be an incidental finding, not always the cause of pain.

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Area of Science:

  • Oncology
  • Neurology
  • Radiology

Background:

  • Sciatica is commonly associated with lumbar disc herniation.
  • Magnetic Resonance Imaging (MRI) is a key diagnostic tool for spinal conditions.

Observation:

  • A 56-year-old male presented with right-sided sciatica and MRI-detected subclinical disc prolapse.
  • Worsening pain and a palpable buttock mass led to further investigation.
  • Imaging revealed an infiltrative mass encasing the lumbosacral plexus.

Findings:

  • Biopsy confirmed the mass as a granulocytic sarcoma, a rare extramedullary tumor of myeloid blasts.
  • The granulocytic sarcoma was the cause of the patient's sciatica symptoms.
  • The intervertebral disc prolapse was an incidental finding on initial MRI.

Implications:

  • This case underscores the importance of considering rare diagnoses in sciatica presentation.
  • It emphasizes that imaging findings like disc herniation may not always correlate with clinical symptoms.
  • Granulocytic sarcoma should be included in the differential diagnosis for patients with unexplained neurological deficits and masses.