Shrinking of a Tarlov cyst

Area of Science:

• Neurology
• Radiology
• Pain Management

Background:

• Tarlov cysts are often asymptomatic but can cause significant pain.
• Diagnosis and treatment of symptomatic Tarlov cysts remain challenging.
• Existing literature lacks documented cases of Tarlov cyst size reduction post-treatment.

Observation:

• A 65-year-old patient presented with left labial and perirectal pain, diagnosed with bilateral Tarlov cysts.
• The symptomatic left Tarlov cyst was treated with image-guided aspiration and fibrin sealant injection.
• The right Tarlov cyst was asymptomatic and not treated.

Findings:

• The treated left Tarlov cyst significantly reduced in size post-procedure.
• This represents a novel outcome, with no prior documented cases of cyst size reduction using this method.
• The patient's pain symptoms were associated with the treated cyst.

Implications:

• Image-guided aspiration and fibrin sealant injection may be an effective treatment for symptomatic Tarlov cysts.
• Increased clinician awareness regarding Tarlov cyst diagnosis and treatment is warranted.
• Potential gender bias in diagnosis and treatment of Tarlov cysts in women should be investigated.