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.
D000328:Adult; D003937:Diagnosis, Differential; D006406:Hematoma / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000000981:diagnostic imaging*; D008297:Male; D009192:Myelography; D013118:Spinal Cord Diseases / Q000000981:diagnostic imaging* / Q000601:surgery; D014057:Tomography, X-Ray Computed