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隐匿性腰椎间盘突出症酷似腰大肌脓肿:一例报告

Sequestered Lumbar Disc Mimicking Psoas Abscess: A Case Report.

作者信息

Suzuki Shu, Okita Kazuya, Abe Kazuki, Suzuki Mizuka, Takaki Yasunobu

机构信息

Diagnostic Radiology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, JPN.

Orthopedics, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, JPN.

出版信息

Cureus. 2025 Feb 27;17(2):e79781. doi: 10.7759/cureus.79781. eCollection 2025 Feb.

Abstract

We present a rare case of a sequestered lumbar disc herniation mimicking a psoas abscess. A 68-year-old male with a history of tongue cancer surgery had a ring-enhancing lesion in the left psoas muscle at the L2/3 level on contrast-enhanced computed tomography (CT), raising concerns about psoas abscesses related to vertebral spondylodiscitis. Magnetic resonance imaging (MRI) revealed a well-defined mass with low signal intensity on T1-weighted images, high signal intensity on T2-weighted images, and surrounding muscle edema. CT-guided biopsy revealed degenerative intervertebral disc tissue without malignancy or acute inflammation, confirming a sequestered disc herniation as the cause. Sequestered disc herniation is a rare condition in which the disc material migrates away from its origin, presenting similarly to infections or tumors. Imaging features such as ring enhancement in contrast studies can complicate the diagnosis. This case highlights the importance of considering sequestered disc herniation in the differential diagnosis of psoas muscle masses. Further research is needed to better understand the pathophysiology and management of sequestered disc herniation in the psoas muscle.

摘要

我们报告一例罕见的隐匿性腰椎间盘突出症,其表现类似腰大肌脓肿。一名有舌癌手术史的68岁男性,在增强计算机断层扫描(CT)上显示L2/3水平左侧腰大肌有环形强化病变,这引发了对与椎体椎间盘炎相关的腰大肌脓肿的担忧。磁共振成像(MRI)显示一个边界清晰的肿块,在T1加权图像上呈低信号强度,在T2加权图像上呈高信号强度,周围有肌肉水肿。CT引导下活检显示为退变的椎间盘组织,无恶性病变或急性炎症,证实隐匿性椎间盘突出症为病因。隐匿性椎间盘突出症是一种罕见情况,即椎间盘物质从其起源处移位,表现类似于感染或肿瘤。造影检查中如环形强化等影像学特征会使诊断复杂化。该病例强调了在腰大肌肿块的鉴别诊断中考虑隐匿性椎间盘突出症的重要性。需要进一步研究以更好地理解腰大肌隐匿性椎间盘突出症的病理生理学和治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c649/11954434/72c9818900ec/cureus-0017-00000079781-i01.jpg

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