The Cervical Sequestrated Disc Fragment Presenting as Mass Lesion: Case Report and Review of the Literature

Background & Importance: Disc herniation is defined as the prolapsed of material disc into the spinal canal. If the disc fragment is free in spinal canal, it is called sequestration disc fragment. Occasionally, alteration in sequestration disc fragment makes the diagnosis of the disc herniation, challenging. Case Presentation: We reviewed a rare case of the cervical sequestrated disc herniation mimicking a spinal canal extradural abscess. The 55-year-old man presented cervical axial and radicular pain. Cervical spine MRI showed an extra-axial longitudinal mass behind C5 and C6 vertebral body association with anterior compression on cord. In T2 images of lesion, the signal intensity varied from isointense to hyperintense and marked peripheral enhancement with GD injection. After unilateral right C6 hemilaminectomy, a sequestrated disc fragment was resected from epidural space. Conclusion: The histopathologic findings were in favor of sequestrated disc herniation. Although MRI is the main preoperative diagnostic tool for accurate diagnosis of the sequestrated disc herniation, the sequestrated disc fragment can show the variable features on MRI and can be misdiagnosed with the other space-occupying lesions.