Presentation
Lumbar pain associated with radicular pain and numbness of the left leg, and foot weakness.
Patient Data
loss of lumbar lordosis
a well-defined cystic lesion is noted at the extra-foraminal zone (Dew/Braithwaite and Lees type 5: paravertebral) at the level of left L5 nerve root, just between the transverse process of L5 and the sacral ala on the left side, compressing the left L5 nerve root and displacing it medially, it is of hypointense cystic wall and hyperintense content on T2 and completely hypointense on T1
another cystic lesion is noted in the liver
Cyst-like lesions in the lower lung zone bilaterally.
Case Discussion
The presence of a hepatic cyst on MRI and the pulmonary cysts on CXR strongly suggest hydatid disease and the positive echinococcus Ab blood test backs up the diagnosis.
The treatment was:
starting albendazole and preparing for right lung and hepatic cysts excision via transthoracic approach
one month later, L-L5 neural foramen cyst excision via a posterior midline approach
The diagnosis was confirmed by pathology (hydatid cyst). And the patient did very well after both operations.
Unable to process the form. Check for errors and try again.