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Published on: March 2, 2020
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Sequestered Lumbar Disc Mimicking Psoas Abscess: A Case Report.
Shu Suzuki1, Kazuya Okita1, Kazuki Abe2
1Diagnostic Radiology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, JPN.
Cureus
|March 31, 2025
Summary
A rare case of sequestered lumbar disc herniation mimicked a psoas abscess. This condition, where disc material migrates, can present as a psoas muscle mass, complicating diagnosis and requiring careful consideration.
Area of Science:
- Neurosurgery
- Radiology
- Orthopedics
Background:
- Lumbar disc herniation is common, but sequestered herniation is rare.
- Psoas abscesses typically present as ring-enhancing lesions on CT scans.
Observation:
- A 68-year-old male presented with a psoas muscle lesion suggestive of an abscess.
- Contrast-enhanced CT showed a ring-enhancing lesion at L2/3.
- MRI revealed a well-defined mass with characteristic signal intensities and surrounding edema.
Findings:
- CT-guided biopsy confirmed degenerative intervertebral disc tissue.
- The lesion was diagnosed as a sequestered lumbar disc herniation.
- No malignancy or acute inflammation was detected.
Implications:
- Sequestered disc herniation can mimic infections like psoas abscess.
- Imaging findings, including ring enhancement, can be misleading.
- This case underscores the importance of including sequestered disc herniation in the differential diagnosis for psoas masses.
