Tarlov cyst: A rare cause of posterior mediastinal mass

Louza, Guilherme Felix; Louza, Isabel Curcio Felix; Zanetti, Gláucia; Marchiori, Edson

doi:10.1016/j.pulmoe.2019.03.001

Cited by 2 publications

(1 citation statement)

References 5 publications

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“…A Tarlov cyst (TC) is defined as a CSF-filled cystic lesion in the epidural space that forms in the nerve root sheath of the dorsal root ganglion. Thoracic TCs are very uncommon and to the best of our knowledge, there was only one reported case of a thoracic TC located in the posterior mediastinum ( 6 ). Therefore, this was the second reported case of a TC in the posterior mediastinum, making it difficult to distinguish it from a neurogenic tumor.…”

Section: Introductionmentioning

confidence: 99%

Case report: Epidural blood patches are effective in treating intracranial hypotension due to a subarachnoid-pleural fistula

et al. 2022

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BackgroundIntracranial hypotension (IH) is usually associated with cerebrospinal fluid (CSF) leakage and/or CSF hypotension, and epidural blood patch (EBP) therapy has been proven to be effective for treating spontaneous IH and post-dural puncture headaches. Tarlov cysts (TCs) are common lesions of the sacral spine. They have rarely been reported in thoracic locations and are even less common in the posterior mediastinum, which can lead to their misdiagnosis as neurogenic tumors.Case presentationHere, we report the case of a 60-year-old woman who developed an orthostatic headache after the thoracoscopic resection of a TC in the posterior mediastinum that was presumed to be a schwannoma preoperatively. The patient was finally diagnosed with IH caused by a subarachnoid-pleural fistula (SPF) and was cured by targeted EBP treatment.ConclusionThis is a case to show that a single targeted EBP treatment is effective for a patient with IH caused by an SPF after thoracoscopic resection of a TC. This case reminds us to be vigilant that a TC may be masquerading as a posterior mediastinal neurogenic tumor, and a detailed examination should be performed to identify it before deciding on a surgical procedure. In addition, postural headache after thoracoscopic spinal surgery should be alert to the possibility of IH induced by an SPF. Once it occurs, early treatment is necessary, and targeted EBP treatment can serve as a safe and effective alternative when conservative treatment fails.

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Section: Introductionmentioning

confidence: 99%