Sequestered disc herniation mimicking psoas abscess: A rare case report.

Area of Science:

• Spine Surgery
• Radiology
• Pathology

Background:

• Intervertebral disc herniation is a common condition, predominantly affecting the lumbar and cervical spine.
• While most lumbar disc herniations occur within the spinal canal, 7%-10% are located in the foramen or extraforaminal regions.
• Extraforaminal disc herniation, particularly in the retroperitoneum, can be challenging to diagnose.

Observation:

• Disc herniations in extraforaminal locations, especially when sequestered (disconnected from the parent disc), can be mistaken for other pathologies.
• A case is presented of a 60-year-old male misdiagnosed with a psoas abscess due to retroperitoneal disc sequestration.
• The patient underwent invasive investigations before a correct diagnosis was established.

Findings:

• Histological confirmation revealed disc sequestration in the retroperitoneum, not an abscess.
• The sequestered disc material presented as a mass in the retroperitoneal space.
• The case highlights the potential for misinterpretation of imaging findings.

Implications:

• Awareness of extraforaminal and sequestered disc herniation is essential for accurate diagnosis.
• Proper identification can prevent unnecessary invasive investigations and treatments.
• This knowledge aids in differentiating disc herniation from conditions like abscesses or neoplasms.