Spinal cord tumor presenting as a herniated lumbar disc

The lesion encountered in this case was that of an intradural-extramedullary tumor. Histologic section showed an organized hematoma, which is a very rare tumor. In a recent review of the literature, only 85 cases have been reported, most in relation to a bleeding intraspinal neoplasm. Our case is especially unusual because there was no clotting abnormality or repeated lumbar punctures or arteriovenous malformation. This case also points out the necessity of a complete physical examination. A CT scan was initially negative because the scan started just below the tumor, hence it was never visualized. Metrizamide myelogram followed by the enhanced CT scan provides a more complete diagnostic study. In this patient's case, the CT scan would have led to inappropriate therapy, whether lumbar laminectomy or chemonucleolysis.