Hemorrhagic synovial lumbar cyst: a case report and review of the literature.
The authors report a case of an 81-year-old woman affected by a synovial cyst arising from the left facet joint of L3. The patient presented with severe pain and claudicatio spinalis. Diagnosis was based upon standard x-rays and MRI; the patient was operated on and the histology of the lesion confirmed the pre-operative diagnosis. On MRI images the lesion appeared as a roundish extradural mass arising from the left facet joint of L3, compressing the cauda equina posteriorly, and it appeared with an increased heterogeneous signal, consistent with a high quantity of fluid and hemosiderin within the cyst. A communication between the lesion and the joint space was evident on the MRI sagittal reconstruction. Grossly the cut surface of the mass had a cystic aspect, with some hemorrhagic areas between whitish myxoid tissue. Histologically the lesion was formed by fibrous connective tissue covered by synovium; focal inflammation and hemosiderin-laden macrophages were also present in some areas. At one year follow-up the patient is symptom-free.
Bandiera
S
S
1a Clinica Ortopedica, Istituto Ortopedico Rizzoli, Bologna, Italia.
Campanacci
L
L
De Iure
F
F
Bertoni
F
F
Picci
P
P
Boriani
S
S
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006470:Hemorrhage / Q000175:diagnosis*; D006801:Humans; D008159:Lumbar Vertebrae; D013122:Spinal Diseases / Q000175:diagnosis*; D013581:Synovial Cyst / Q000175:diagnosis*