Lumbar Disc Herniation with End-Plate Fracture and Secondary Ossification Mimicking an Epidural Tumor: A Case Report

Koun Yamauchi, Akira Hioki, Kazunari Fushimi, Kei Miyamoto, Katsuji Shimizu

Department of Orthopaedic Surgery, Gifu University School of Medicine, Gifu, Japan.
Department of Orthopaedic Surgery, Hikone Municipal Hospital, Shiga, Japan.
Department of Orthopaedic Surgery, Kizawa Memorial Hosptial, Gifu, Japan.
Department of Reconstructive Surgery for Spine, Bone, and Joint, Gifu University School of Medicine, Gifu, Japan.

DOI: 10.4236/ojo.2013.32020                

Abstract

We report a unique case of lumbar disc herniation, in particular, with end-plate and surrounded by extensive ossification, mimicking a tumor with calcification. A 69-year-old female suffered from right buttock and leg pain. Computed tomography (CT) showed an intracanalar mass with calcification or ossification, which most likely originated from the vertebral body at the L1/2 level epidural space. On a T1-weighted gadolinium magnetic resonance image, the capsule of the mass was enhanced and not only the content of the mass but also that of the L2 vertebral body were partially and slightly enhanced. The final pathological diagnosis was disc herniation with end-plate fracture and secondary ossification. A combination of these pathological conditions as accompanied by both end-plate fractures and extensive secondary ossifications has not been previously reported. This rare pathological condition needs to be recognized as a differential diagnosis.

Keywords

Disc Herniation; Extensive Ossifications; End-Plate Fractures

Conflicts of Interest

The authors declare no conflicts of interest.

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