J Korean Soc Spine Surg.  2016 Jun;23(2):127-130. 10.4184/jkss.2016.23.2.127.

Huge Intradural Lumbar Disc Herniation Mimicking an Intradural Spinal Tumor: A Case Report

• Shin CS
• Choi BY
• Kim KT

• KMID: 2328007
• DOI: http://doi.org/10.4184/jkss.2016.23.2.127

Abstract

STUDY DESIGN: A case report.
OBJECTIVES
To report a case of cauda equine syndrome due to a lumbar intradural disc herniation. SUMMARY OF LITERATURE REVIEW: IDH is rare but there is a higher incidence of neurologic deficit in IDH. Therefore, it should be treated immediately.
MATERIALS AND METHODS
A 34-year-old male patient was presented with cauda equina syndrome due to a lumbar intradural mass and underwent surgical excision.
RESULTS
Operative findings and the histologic study revealed an intradural disc herniation.
CONCLUSIONS
IDH is very rare lesion but should be considered in a differential diagnosis if preoperative MRI demonstrates an intradural lesion.

Keyword

Lumbar spine; Cauda equina syndrome; Intradural disc herniation

MeSH Terms

Adult
Diagnosis, Differential
Humans
Incidence
Magnetic Resonance Imaging
Male
Neurologic Manifestations
Polyradiculopathy

Figure

• 

  Fig. 1. (A) The arrow indicates a huge isointense mass-like lesion located in the intradural space from the L4 to L5 level on a T1-weighted sagittal magnetic resonance (MR) image. (B) The arrow indicates a heteroge-neous isointense lesion in a T2-weighted sagittal MR image.

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  Fig. 2. The arrow indicates ring enhancement of the mass on a gadolini-um-enhanced T1-weighted axial magnetic resonance (MR) image.

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  Fig. 3. An intraoperative image demonstrates a huge intradural disc fragment after durotomy.

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  Fig. 4. A clinical photo shows the piece of disc material that was re-moved.

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