Abdominal pain secondary to a sacral perineural cyst.
BACKGROUND
Perineural cysts are commonly found in the sacral region and are incidently discovered on imaging studies performed for the evaluation of low back and/or leg pain.


OBJECTIVE
To report on a patient presenting with abdominal pain secondary to a large sacral perineural cyst.


METHODS
Case report. METHODS/PATIENT SAMPLE: A 47-year-old woman was referred to a specialized multidisciplinary spine center with complaints of left lower quadrant abdominal pain and left leg pain. Of significant note was the presence of constipation and urinary frequency over the preceding 8 months. Physical examination was normal. Magnetic resonance imaging of the lumbosacral spine revealed large perineural cysts eroding the sacrum and extending to the pelvis. The presence of abdominal symptoms prompted a neurosurgical consultation. However, after considering the possible risks associated with the surgical procedure, the patient opted to follow the nonsurgical route.


CONCLUSIONS
Although commonly visualized, sacral perineural cysts are rarely symptomatic. When symptomatic, it may be secondary to its size and location. Presence of abdominal pain in a patient with back and/or leg pain should prompt the evaluation of the lumbosacral spine.
Penn Spine Center Research Group, Department of Rehabilitation Medicine, Hospital of University of Pennsylvania, Philadelphia, PA 19104, USA. slipman@mail.med.upenn.edu
Curtis W
CW
Slipman
Atul L
AL
Bhat
Sarjoo M
SM
Bhagia
Zacharia
Z
Issac
Russell V
RV
Gilchrist
David A
DA
Lenrow
D015746:Abdominal Pain / Q000209:etiology / Q000473:pathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D012447:Sacrum / Q000473:pathology*; D012585:Sciatica / Q000209:etiology / Q000473:pathology; D052958:Tarlov Cysts / Q000150:complications / Q000473:pathology*