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Case Reports
. 2011 Apr;49(4):237-40.
doi: 10.3340/jkns.2011.49.4.237. Epub 2011 Apr 30.

A ganglion cyst in the second lumbar intervertebral foramen

Sang Woo Kim  1 , Joon Hyuk Choi, Min Su Kim, Chul Hoon Chang
Affiliations
Case Reports

A ganglion cyst in the second lumbar intervertebral foramen

Sang Woo Kim et al. J Korean Neurosurg Soc. 2011 Apr.

Abstract

Ganglion cysts usually arise from the tendon sheaths and tissues around the joints. It is usually associated with degenerative arthritic changes in older people. Ganglion cyst in the spine is rare and there is no previous report on case that located in the intervertebral foramen and compressed dorsal root ganglion associated severe radiculopathy. A 29-year-old woman presented with severe left thigh pain and dysesthesia for a month. Magnetic resonance imaging revealed a dumbbell like mass in the intervertebral foramen between second and third lumbar vertebrae on the left side. The lesion was removed after exposure of the L2-L3 intervertebral foramen. The histological examination showed fragmented cystic wall-like structure composed of fibromyxoid tissue but there was no lining epithelium. A ganglion cyst may compromise lumbar dorsal root ganglion when it located in the intervertebral foramen. Although it is very rare location, ganglion cyst should be included in the differential diagnosis for intervertebral foraminal mass lesions.

Keywords: Ganglion cyst; Lumbar vertebra; Posterior longitudinal ligament; Radiculopathy.

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Figures

Fig. 1
Fig. 1
A and B : MR imaging reveals a dumbbell like mass in the intervertebral foramen between second and third lumbar vertebrae on the left side (arrow). C : Gadolinium-DTPA administration increases the signal intensity at the periphery of the mass. D and E : MR coronal view shows multi-loculated extradural cysts in the intervertebral foraminen (arrows).
Fig. 2
Fig. 2
A : Following the exposure of the foramen, the mass is found to compress the dura and the left L2 nerve root (arrow). B : The cyst is connected to a posterior longitudinal ligament with stalk (arrow). C : L2 nerve root and DRG is be seen after removal of the cyst.
Fig. 3
Fig. 3
Microscopic findings. A : The tissue shows cystic wall-like structure composed of fibromyxoid tissue (arrow). The lining epithelium is not present (H & E stain, ×100). B: Alcian blue stain shows blue-tinged myxoid change (arrow) (Alcian blue stain, ×100).
See this image and copyright information in PMC

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