Lumbar Epidural Varix Mimicking Perineural Cyst
A 36-year-old male patient presented to our hospital with right leg pain. He was healthy otherwise. In his neurological examination, mild motor weakness was detected on the plantar flexion of the right foot, as well as absence of the achille reflex on the right side. The MR imaging revealed a hyperintense cystic lesion at the S1 level with compression on the right spinal root and dural sac (). The radiological diagnosis was perineural cyst. The patient underwent surgery and right L5-S1 hemilaminectomy was performed. A brown-soft mass lesion, which was in connection with the epidural venous plexus, was identified during surgery ().\nThis lesion became smaller after coagulation and was removed after cutting the connections with epidural plexus. No massive bleeding occured during the resection of the lesion. The spinal root and dural sac were decompressed. The histological examination of the lesion showed tortuous and dilated vessels that were consistent with the diagnosis of varix (). The patient was clinically improved after surgery. The postoperative MR imaging at the third month after surgery showed the absence of the varix ().