Posterior epidural mass: can a posteriorly migrated lumbar disc fragment mimic tumour, haematoma or abscess?
A 60-year-old woman complained of low back pain radiating to both buttocks and to the anterior aspect of the left thigh. MRI showed a left posterolateral epidural mass at the L1-L2 level. An epidural abscess was suspected, but the biochemistry was normal. Excision yielded complete relief of symptoms. Pathological examination demonstrated that the specimen was a migrated disc fragment. The authors found 29 other cases of disc migration to the posterior epidural space; two of these were at the thoracic level. Eleven of the 27 lumbar cases (40%) were complicated with Cauda Equina Syndrome (CES). MRI is the method of choice to make the diagnosis. The differential diagnosis includes tumour, haematoma and abscess.
Derincek
Alihan
A
Baskent University School of Medicine, Department of Orthopaedics and Traumatology, Adana Medical Center, Adana, Turkey. aderincek@hotmail.com
Ozalay
Metin
M
Sen
Orhan
O
Pourbagher
Ayşin
A
D000038:Abscess / Q000175:diagnosis; D003937:Diagnosis, Differential; D004824:Epidural Space; D005260:Female; D005548:Foreign-Body Migration / Q000175:diagnosis*; D006406:Hematoma / Q000175:diagnosis; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000150:complications*; D007796:Laminectomy; D008159:Lumbar Vertebrae; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D011128:Polyradiculopathy / Q000209:etiology; D013122:Spinal Diseases / Q000175:diagnosis; D013125:Spinal Neoplasms / Q000175:diagnosis; D013168:Spondylolisthesis / Q000175:diagnosis