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Sequestrated Lumbar Disc Herniation Mimicking Spinal Neoplasm.
Faisal Konbaz1, Sami I Aleissa1, Fahad Al Helal1
1Department of Orthopaedic Surgery, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, SAU.
Cureus
|November 12, 2021
Summary
This case highlights a rare instance where sequestered lumbar disc fragments mimicked a spinal neoplasm, presenting diagnostic challenges. Prompt surgical intervention and biopsy confirmed both disc fragments and acute leukemia, leading to improved patient outcomes.
Area of Science:
- Neurosurgery
- Oncology
- Radiology
Background:
- Sequestered lumbar disc fragments can present with symptoms mimicking spinal neoplasms.
- Accurate diagnosis and treatment pose significant clinical challenges due to overlapping presentations.
Observation:
- A 70-year-old male presented with chronic low back pain and acute lower extremity weakness, initially suspected as a spinal tumor.
- MRI revealed an epidural mass at L2-L3 causing cauda equina compression, prompting surgical intervention.
- Biopsies confirmed sequestered disc fragments and, unexpectedly, acute leukemia in the bone.
Findings:
- Surgical decompression and mass excision were performed for the L2-L3 epidural mass.
- Histopathology revealed fibrocartilaginous tissue consistent with intervertebral disc material.
- Bone biopsy diagnosed acute leukemia, indicating a dual pathology.
Implications:
- This case underscores the importance of considering rare differential diagnoses for spinal masses.
- Vigilant clinical evaluation and comprehensive diagnostic workup are crucial for identifying complex pathologies.
- Early diagnosis and appropriate management of both disc herniation and underlying malignancy are vital for patient recovery.
