PMC9990805_01
Preoperative magnetic resonance imaging without contrast before first surgery. (a) T2 parasagittal fat suppression. Cystic-appearing lesion in the left L3-4 neural foramen visible on (b) T2 axial at L3-4.
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F1
Magnetic resonance imaging (MRI) revealed a cystic-appearing lesion in the left L3-4 neural foramen, thought to be a left-sided extraforaminal disc herniation [Figure 1].
Postoperative magnetic resonance imaging without contrast after first surgery. (a) T2 parasagittal. Cystic-appearing lesion approximately 1.4 x 1.0 cm in the left L3-4 neural foramen visible on (b) T2 axial at L3-4.
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F2
A second MRI revealed a cystic mass approximately 1.4 x 1.0 cm on the left at L3-L4 extraforaminally; it was diagnosed as a postoperative seroma [Figure 2].
Preoperative magnetic resonance imaging before second surgery. (a) T2 parasagittal without contrast. Progressive enlargement of lesion in the left L3-4 neural foramen with marked mass effect on the exiting L3 nerve visible on (b) T2 axial without contrast at L3-4. (c) T2 parasagittal without contrast. Redemonstration of lobulated T2-hyperintense mass measuring 2.5 x 2.4 x 2 cm centered in the left neural foramen visible on (d) T2 axial without contrast at L3-4. Peripherally enhancing cystic mass visible on (e) T1 parasagittal with contrast and (f) T1 axial with contrast at L3-4.
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F3
The mass was continuous with the annulus fibrosus [Figure 3].
Hematoxylin and eosin staining of the specimen. (a and b) Cellularity is somewhat increased compared to normal cartilage, but there is only mild atypia, no mitoses, and no myxoid areas. (c) Lobulated architecture of the cartilaginous neoplasm. (d) Bland histologic features, no atypia, no mitoses, favoring a benign extraosseous chondroid lesion. (e) A rare focus of mild atypia in the otherwise histologically bland neoplasm.
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F4
These findings were consistent with a benign extraosseous chondroid lesion, most likely chondroma versus chondromatosis [Figure 4].