Far Lateral Disc Herniation Imitating Nerve Sheath Tumor: Case Report

M. Bruder, S. Theuss, Seifert, G. Marquardt
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Abstract

We present the case of a 57-year-old female with sciatica, paresis and paresthesia of the left leg. MRI obviously revealed an enlarged L3 nerve root with circumjacent gadolinium enhancement. Due to these findings a schwannoma was suspected. Operation was performed using a lateral approach. However, no nerve sheath tumor was encountered intraoperatively but a far lateral disc herniation exerting considerable pressure on the nerve root. Histopathological examination confirmed this diagnosis, and surgical resection resulted in complete relief. According to these findings, far lateral disc herniation should be considered as a differential diagnosis in case of an enlarged nerve root with marginal gadolinium enhancement.
模拟神经鞘肿瘤的远外侧椎间盘突出1例
我们提出的情况下,一个57岁的女性坐骨神经痛,轻瘫和感觉异常的左腿。MRI显示L3神经根肿大,周围钆增强。由于这些发现,我们怀疑是神经鞘瘤。手术采用外侧入路。然而,术中没有神经鞘肿瘤,但远外侧椎间盘突出对神经根施加了相当大的压力。组织病理学检查证实了这一诊断,手术切除导致完全缓解。根据这些发现,当神经根扩大并伴有边缘钆增强时,应考虑远外侧椎间盘突出作为鉴别诊断。
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