title: A migrated lumbar disc herniation simulating a dumbbell tumor.
abstract: We report a case of a migrated lumbar disc hemiation, which on magnetic resonance imaging (MRI) simulated a dumbbell tumor in a 44-year-old woman who had severe pain in her right buttock and leg. A large epidural mass mimicking a dumbbell tumor was detected at the L5 vertebral level by MRI and computed tomography over myelography. Surgical fenestration of the L4/L5 interlaminar space revealed a dorsolateral epidural mass connected to the L5/S1 intervertebral disc extending laterally through the right L5/S1 intervertebral foramen. Histologically, it was degenerative disc material without active inflammation. Reevaluation of the MRI suggested some clues that might be useful in differentiating such a herniated disc from an epidural tumor.
authors.affiliation: Department of Orthopedic Surgery, Shiga University of Medical Science, Otsu, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Saruhashi
authors.forename: K
authors.initials: K
authors.lastname: Omura
authors.forename: K
authors.initials: K
authors.lastname: Miyamoto
authors.forename: A
authors.initials: A
authors.lastname: Katsuura
authors.forename: S
authors.initials: S
authors.lastname: Hukuda
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D004824:Epidural Space; D005260:Female; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D017116:Low Back Pain / Q000209:etiology; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging* / Q000601:surgery; D008279:Magnetic Resonance Imaging; D009192:Myelography; D009408:Nerve Compression Syndromes / Q000209:etiology; D009442:Neurilemmoma / Q000175:diagnosis*; D012585:Sciatica / Q000209:etiology; D013125:Spinal Neoplasms / Q000175:diagnosis*; D013126:Spinal Nerve Roots; D014057:Tomography, X-Ray Computed