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Case Reports
. 2014 Aug;4(3):175-8.
doi: 10.1055/s-0033-1363591. Epub 2013 Dec 19.

Giant, completely calcified lumbar juxtafacet cyst: report of an unusual case

Kevin T Huang  1 , Timothy R Owens  1 , Teresa S Wang  1 , Jessica R Moreno  1 , Jacob H Bagley  1 , Carlos A Bagley  1
Affiliations
Case Reports

Giant, completely calcified lumbar juxtafacet cyst: report of an unusual case

Kevin T Huang et al. Global Spine J. 2014 Aug.

Abstract

Study Design Case report. Objective To report the case of one patient who developed a giant, completely calcified, juxtafacet cyst. Methods A 57-year-old woman presented with a 2-year history of progressively worsening lower back pain, left leg pain, weakness, and paresthesias. Imaging showed a giant, completely calcified mass arising from the left L5-S1 facet joint, with coexisting grade I L5 on S1 anterolisthesis. The patient was treated with laminectomy, excision of the mass, and L5-S1 fixation and fusion. Results The patient had an uncomplicated postoperative course and had complete resolution of her symptoms as of 1-year follow-up. Conclusions When presented with a solid-appearing, calcified mass arising from the facet joint, a completely calcified juxtafacet cyst should be considered as part of the differential diagnosis.

Keywords: case report; complete calcification; juxtafacet cyst; synovial cyst.

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Conflict of interest statement

Disclosures None

Figures

Fig. 1
Fig. 1
Preoperative plain film of the lumbar spine showing a large, completely calcified lesion extending out from the L5–S1 intervertebral space.
Fig. 2
Fig. 2
(a) Axial computed tomography (CT) image taken preoperatively, showing the origin of the lesion from the left L5–S1 facet joint. (b) A preoperative midsagittal CT image demonstrating grade 1 anterolisthesis of L5 on S1. (c) A preoperative sagittal CT image demonstrating foraminal stenosis at L5–S1 caused by the lesion.
Fig. 3
Fig. 3
(a) T1-weighted magnetic resonance image (MRI) of the same lesion, which appears uniformly hypointense. (b) T2-weighted MRI, also demonstrating uniform hypointensity.
Fig. 4
Fig. 4
(a) Hematoxylin and eosin–stained sections of the resection reveal dense membranous fibrous connective tissue separating spaces associated with dense calcifications as well as smaller loculated spaces filled with calcium (×20 magnification). (b) Higher magnification (×40) reveals the wall of the spaces to be associated with granular calcifications and no obvious cellular lining.
Fig. 5
Fig. 5
(a) Postoperative plain film (anterior-posterior) showing removal of the mass and placement of fixation hardware. (b) Lateral view of the same.
See this image and copyright information in PMC

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