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Sequestrated Lumbar Disc Herniation Mimicking Spinal Neoplasm
Sequestered disc fragments do not have indistinctive features and often share the clinical and radiological presentation as spinal neoplasms making their diagnosis and treatment a clinical challenge. We report a rare case of sequestered lumbar disc fragment at the level of L2-L3 in a 70-year-old mal...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Cureus
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8573969/ https://www.ncbi.nlm.nih.gov/pubmed/34765331 http://dx.doi.org/10.7759/cureus.18529 |
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author | Konbaz, Faisal Aleissa, Sami I Al Helal, Fahad Abaalkhail, Majed Alrogy, Waleed Bin Dohaim, Abrar Albishi, Nasser |
author_facet | Konbaz, Faisal Aleissa, Sami I Al Helal, Fahad Abaalkhail, Majed Alrogy, Waleed Bin Dohaim, Abrar Albishi, Nasser |
author_sort | Konbaz, Faisal |
collection | PubMed |
description | Sequestered disc fragments do not have indistinctive features and often share the clinical and radiological presentation as spinal neoplasms making their diagnosis and treatment a clinical challenge. We report a rare case of sequestered lumbar disc fragment at the level of L2-L3 in a 70-year-old male who presented to the ER complaining of six years' history of low back pain with acute onset lower extremities weakness for six days, associated with right foot drop. He was admitted for tumor workup as the MRI showed diffuse bone high signal intensity throughout the spine with a soft tissue epidural mass at L2/3, causing severe compression on the cauda equina nerve roots. The patient underwent L2-L3 decompression and fixation, mass excision, multiple open biopsies. Soft tissue biopsy of the mass revealed fibrocartilaginous tissue consistent with the intervertebral disc, while the bone biopsy was diagnostic of acute leukemia. The patient was observed postoperatively with unremarkable complications. He did well with physiotherapy, and there was a remarkable improvement of his right lower extremity power reaching 4/5. Our case presented a rare phenomenon in which sequestered disc fragments manifested clinically and radiologically as a spinal neoplasm. Vigilant history taking and physical examination are paramount; a physician should be watchful for any red flags that may warrant further investigation such as in our case. |
format | Online Article Text |
id | pubmed-8573969 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Cureus |
record_format | MEDLINE/PubMed |
spelling | pubmed-85739692021-11-10 Sequestrated Lumbar Disc Herniation Mimicking Spinal Neoplasm Konbaz, Faisal Aleissa, Sami I Al Helal, Fahad Abaalkhail, Majed Alrogy, Waleed Bin Dohaim, Abrar Albishi, Nasser Cureus Neurosurgery Sequestered disc fragments do not have indistinctive features and often share the clinical and radiological presentation as spinal neoplasms making their diagnosis and treatment a clinical challenge. We report a rare case of sequestered lumbar disc fragment at the level of L2-L3 in a 70-year-old male who presented to the ER complaining of six years' history of low back pain with acute onset lower extremities weakness for six days, associated with right foot drop. He was admitted for tumor workup as the MRI showed diffuse bone high signal intensity throughout the spine with a soft tissue epidural mass at L2/3, causing severe compression on the cauda equina nerve roots. The patient underwent L2-L3 decompression and fixation, mass excision, multiple open biopsies. Soft tissue biopsy of the mass revealed fibrocartilaginous tissue consistent with the intervertebral disc, while the bone biopsy was diagnostic of acute leukemia. The patient was observed postoperatively with unremarkable complications. He did well with physiotherapy, and there was a remarkable improvement of his right lower extremity power reaching 4/5. Our case presented a rare phenomenon in which sequestered disc fragments manifested clinically and radiologically as a spinal neoplasm. Vigilant history taking and physical examination are paramount; a physician should be watchful for any red flags that may warrant further investigation such as in our case. Cureus 2021-10-06 /pmc/articles/PMC8573969/ /pubmed/34765331 http://dx.doi.org/10.7759/cureus.18529 Text en Copyright © 2021, Konbaz et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Neurosurgery Konbaz, Faisal Aleissa, Sami I Al Helal, Fahad Abaalkhail, Majed Alrogy, Waleed Bin Dohaim, Abrar Albishi, Nasser Sequestrated Lumbar Disc Herniation Mimicking Spinal Neoplasm |
title | Sequestrated Lumbar Disc Herniation Mimicking Spinal Neoplasm |
title_full | Sequestrated Lumbar Disc Herniation Mimicking Spinal Neoplasm |
title_fullStr | Sequestrated Lumbar Disc Herniation Mimicking Spinal Neoplasm |
title_full_unstemmed | Sequestrated Lumbar Disc Herniation Mimicking Spinal Neoplasm |
title_short | Sequestrated Lumbar Disc Herniation Mimicking Spinal Neoplasm |
title_sort | sequestrated lumbar disc herniation mimicking spinal neoplasm |
topic | Neurosurgery |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8573969/ https://www.ncbi.nlm.nih.gov/pubmed/34765331 http://dx.doi.org/10.7759/cureus.18529 |
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