Tumor or hematoma? : An unusual case of an extradural lesion of the lumbar spine

Clin Neuroradiol. 2013 Dec;23(4):305-8. doi: 10.1007/s00062-012-0187-5. Epub 2012 Dec 4.

Abstract

Purpose: Spinal epidural hematoma is a rare clinical entity. We present a case of atypical contrast enhancement pattern in a chronic epidural hematoma of the lumbar spine mimicking an extradural tumor.

Case report: A 76-year-old man on treatment with oral anticoagulants presented with a 1-month history of lower back pain radiating into his right upper thigh accompanied by spinal claudication. Preoperative MRI showed a posterior epidural lesion compressing the cauda equina with almost homogeneous contrast enhancement. Surgery was performed under the presumptive diagnosis of spinal extradural neoplasm. Intraoperative and histological findings were consistent with a chronic spinal epidural hematoma. Postoperatively, the patient had instant relief of his symptoms.

Conclusion: Chronic spinal epidural hematoma may resemble an extradural tumor, requiring surgery for histological confirmation and decompression.

Publication types

  • Case Reports
  • Letter

MeSH terms

  • Aged
  • Diagnosis, Differential
  • Hematoma, Epidural, Spinal / complications*
  • Hematoma, Epidural, Spinal / diagnosis*
  • Hematoma, Epidural, Spinal / surgery
  • Humans
  • Magnetic Resonance Imaging / methods*
  • Male
  • Spinal Cord Compression / diagnosis*
  • Spinal Cord Compression / etiology*
  • Spinal Cord Compression / prevention & control
  • Spinal Neoplasms / complications*
  • Spinal Neoplasms / diagnosis*
  • Spinal Neoplasms / surgery
  • Treatment Outcome