EXTREME LATERAL DISC HERNIATION MANIFESTING AS NERVE SHEATH TUMOR - CASE-REPORT

This report discusses the clinical features of a patient who presented with an L-3 radiculopathy in whom magnetic resonance imaging demonstr ated what appeared to be a nerve sheath tumor in an extraforaminal loc ation on the L-3 nerve root. A lateral intermuscular approach to excis e the lesion was used to preserve the facet joint. Histological examin ation of the intraneural lesion revealed degenerative disc fragments. The authors hypothesize that the structure of the annulus fibrosus in the upper lumbar region predisposes these regions to lateral herniatio n. Furthermore, it is proposed that the lateral disc herniation allowe d the disc fragments to erode through the epineurium of the neural she ath. This case expands the differential diagnosis of fusiform enlargem ent of nerves to include disc herniation.