Thickening Ligamentum Flavum Mimicking Tumor in the Epidural Space of the Cervical Spine

Korean Journal of Neurotrauma
Sung Hyun BaeGeun Sung Song

Abstract

In patients with tumors and spinal cord lesions, inflammation and tissue infection can result in mass effect detection on imaging. As a result, surgical biopsy procedures are often performed on the lesions. We report a rare case in which the thickening ligamentum flavum (LF) appeared to be a tumor in the epidural space of the cervical spine based on imaging findings. A 52-year-old man visited our outpatient clinic with severe shoulder pain and radicular pain in his right arm that had developed gradually after a traffic accident two months earlier. Magnetic resonance imaging of the cervical spine revealed an extradural mass at the cervicothoracic junction level. Suspecting a tumor, spinal decompression surgery was performed and a biopsy of the mass was obtained. At the time of surgery, the LF was thick and compressed the spinal cord. After successful removal of the LF, the spinal cord appeared normal. Histopathological examination confirmed the mass as the LF. The patient was discharged without pain or weakness two weeks postoperatively. This case demonstrated that when the LF of the cervicothoracic junction is thickened, it may be misdiagnosed as a cervical spine tumor compressing the spinal cord.

References

Nov 1, 1987·Radiology·N GrenierM K Dalinka
Oct 28, 1997·Investigative Radiology·V M RungeN M Williams
Nov 1, 1951·The Journal of Bone and Joint Surgery. British Volume·A R TAYLOR
Apr 15, 2004·European Journal of Radiology·J W M Van GoethemP M Parizel
Nov 14, 2007·The Spine Journal : Official Journal of the North American Spine Society·Paul C IvancicManohar M Panjabi
Mar 13, 2009·Archives of Orthopaedic and Trauma Surgery·Tadanori SakamakiHiroshi Mikami
Jun 23, 2015·The Spine Journal : Official Journal of the North American Spine Society·Guibin ZhongJeffrey C Wang

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