Intradural disc mimicking: a spinal tumor lesion

Abstract

Study design: A case report of intradural disc hernia mimicking an intradural extramedullary spinal tumor lesion in radiological evaluation.

Objective: To describe a lumbar intradural disc herniation with atypical radiological appearance and point out the role of contrast magnetic resonance imaging (MRI) of the lumbar spine.

Setting: Turkey.

Case report: A 58-year-old man with suspected lumbar intradural mass and neurological involvement received L5 total laminectomy. L5 total laminectomy was performed, and on inspection dura was swollen and immobile. A longitudinal incision was made in the dura and an intradural-free disc fragment was removed. The patient's postoperative period was uneventful and he had full recovery in 3 months.

Conclusions: Lumbar intradural disc rupture must be considered in the differential diagnosis of mass lesions causing nerve root or cauda equina syndromes. Contrast-enhanced MRI scans are useful to differentiate a herniated disc from a disc space infection or tumor. This case demonstrates the role and the importance of contrast MRI in the diagnosis of intradural disc herniation.