title: Posterior epidural disc herniation at L3-L4 mimicking a spinal tumor: a case report.
abstract: Posterior epidural disc migration is a rare event. Many differential diagnoses are possible in the posterior epidural space other than disc disease. This is a case report of L3-L4 posterior epidural disc herniation that was misdiagnosed as a tumor depending on the preoperative magnetic resonance imaging study with a peripheral ring enhancement around the mass lesion after IV gadolinium. Decompressive L4 laminectomy was performed and a free disc fragment was observed beneath the lamina. There wasneither dural tearnor attachment to it. The patient was free of pain postoperatively. After 3 months, the patient applied to the outpatient clinic for a regular control T he patient was neurologically intact and free of pain. Diagnosis of posterior migrated disc fragment with subtle clinical findings, even though the free fragment has to pass through many anatomical barriers including the nevre roots, is a clinical challenge. Many differential diagnoses should be kept in mind. MRI findings (especially with contrast material use) are useful which should be imprinted with clinical knowledge.
authors.affiliation: Department of Neurosurgery, Marmara University Faculty of Medicine, Istanbul, Turkey.
authors.forename: M S
authors.initials: MS
authors.lastname: Ekşi
authors.forename: U
authors.initials: U
authors.lastname: Yener
authors.forename: A
authors.initials: A
authors.lastname: Akakin
authors.forename: D
authors.initials: D
authors.lastname: Akakin
authors.forename: D
authors.initials: D
authors.lastname: Konya
mesh_terms: D003937:Diagnosis, Differential; D004824:Epidural Space / Q000473:pathology; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000473:pathology* / Q000601:surgery; D007796:Laminectomy; D008159:Lumbar Vertebrae / Q000473:pathology* / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D013125:Spinal Neoplasms / Q000473:pathology*; D016896:Treatment Outcome