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Summary
A rare sacral neurinoma case highlights a 54-year history of persistent low back pain. Diagnosis occurred late, with the tumor presenting as a slow-growing, intra-osseous mass originating from sacral nerves.
Area of Science:
- Oncology
- Neurology
- Radiology
Background:
- Neurinomas, typically benign nerve sheath tumors, can occur in various locations, including the sacrum.
- Intra-osseous sacral neurinomas are exceptionally rare, often presenting with a prolonged, indolent clinical course.
Observation:
- A 67-year-old woman presented with a 54-year history of intermittent low back pain (lumbago and sacralgia).
- Late-stage symptoms included motor and sensory deficits in the lower extremities, sphincter paralysis, and sacral decubitus.
- Radiological imaging identified a 6 x 9 cm intra-osseous mass in the left sacrum and iliac bone.
Findings:
- Histopathological examination confirmed a sacral neurinoma.
- The tumor's exclusively intra-osseous location and slow progression were notable.
- The late onset of cauda equina syndrome was a key diagnostic feature.
Implications:
- This case underscores the importance of considering rare diagnoses in patients with chronic, unexplained low back pain.
- Early detection of sacral neurinomas, despite their rarity, is crucial for preventing neurological deficits.
- Understanding the typical presentation and radiological characteristics aids in timely diagnosis and management of these intra-osseous neoplasms.