An extreme lateral lumbar disc herniation mimicking XXXX .

@entity808 @entity1 @entity1931 @entity5 @entity1109 @entity158 @entity2287
OBJECTIVE: We herein describe a case with an extraspinal mass distorting the right L4 dorsal root ganglion. Initially presumed to be a nerve root @entity808 , the lesion turned out to be a free disc fragment. METHODS AND RESULTS: A 46-year-old @entity1 presented with a history of mild low back and intense right leg @entity158 . The leg @entity158 was like electrical discharges. Right knee extension was weak together with @entity1931 and @entity1109 in the right LA dermatome. The right patellar reflex was absent. Electromyography showed acute and chronic denervation of muscles innervated by the right L4 nerve root. MR scan showed a right L4-5 extraforaminal mass distorting the L4 dorsal root ganglion. The mass enhanced homogeneously after @entity2287 injection and was thought to be a @entity5 . It was surgically removed using a midline incision and intraspinal, followed by extraspinal dissection. Under the operating microscope, the mass extended between an intact lateral longitudinal ligament and a swollen dorsal root ganglion. Histopathologic examination ruled out a @entity5 and showed that the mass consisted of degenerated disc material surrounded by a large peripheral zone of neovascularization. CONCLUSION: Extraforaminal periganglionic free, encapsulated disc fragments may mimic tumoral masses, from which they may not be distinguished on MRI.
