2016PubMedOpen access

Intra-radicuar Disc Herniation mimicking a Nerve Root Tumor.

Suresh Pillai

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Abstract

INTRODUCTION: Intra-radicular disc herniations are rare disorders with only few cases reported in literature. In most of these cases there is evidence of some part of the disc in adjacent area. We present a case of completely intra-radicular disc which was misdiagnosed as nerve root tumor as there was no evidence of disc prolapse at the time of diagnosis. CASE PRESENTATION: 51 year old male presented with history of severe back pain radiating to right lower limb since 11/2 month. MRI showed hypointense lesion completely inside the S1 root and a provisional diagnosis of nerve root tumor was done. At surgery, fluffy material was removed from the lesion which was histopathologically confirmed as intervertebral disc. Post operatively all symptoms of patient was relieved except dysesthesia in sole which lasted for a year post surgery. At 5 year follow up patient has no symptoms. CONCLUSION: A diagnosis of intra-radicular disc should be considered in differential of nerve root tumor. Surgical excision of intra-radicular disc gives good clinical and functional results.

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INTRODUCTION: Intra-radicular disc herniations are rare disorders with only few cases reported in literature. In most of these cases there is evidence of some part of the disc in adjacent area. We present a case of completely intra-radicular disc which was misdiagnosed as nerve root tumor as there was no evidence of disc prolapse at the time of diagnosis. CASE PRESENTATION: 51 year old male presented with history of severe back pain radiating to right lower limb since 11/2 month. MRI showed hypointense lesion completely inside the S1 root and a provisional diagnosis of nerve root tumor was done. At surgery, fluffy material was removed from the lesion which was histopathologically confirmed as intervertebral disc. Post operatively all symptoms of patient was relieved except dysesthesia in sole which lasted for a year post surgery. At 5 year follow up patient has no symptoms. CONCLUSION: A diagnosis of intra-radicular disc should be considered in differential of nerve root tumor. Surgical excision of intra-radicular disc gives good clinical and functional results.

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Available abstract

INTRODUCTION: Intra-radicular disc herniations are rare disorders with only few cases reported in literature. In most of these cases there is evidence of some part of the disc in adjacent area. We present a case of completely intra-radicular disc which was misdiagnosed as nerve root tumor as there was no evidence of disc prolapse at the time of diagnosis. CASE PRESENTATION: 51 year old male presented with history of severe back pain radiating to right lower limb since 11/2 month. MRI showed hypointense lesion completely inside the S1 root and a provisional diagnosis of nerve root tumor was done. At surgery, fluffy material was removed from the lesion which was histopathologically confirmed as intervertebral disc. Post operatively all symptoms of patient was relieved except dysesthesia in sole which lasted for a year post surgery. At 5 year follow up patient has no symptoms. CONCLUSION: A diagnosis of intra-radicular disc should be considered in differential of nerve root tumor. Surgical excision of intra-radicular disc gives good clinical and functional results.

Key concepts: Medicine, Dysesthesia, Radicular pain, Nerve root, Disc herniation, Lesion, Differential diagnosis, Surgery

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