# Sequestered Lumbar Disc Mimicking Psoas Abscess: A Case Report

## TL;DR

A rare case of a sequestered lumbar disc was mistaken for a psoas abscess, highlighting the need for accurate diagnosis in similar presentations.

## Contribution

This case report adds to the understanding of sequestered disc herniation mimicking psoas abscess and emphasizes diagnostic challenges.

## Key findings

- A 68-year-old male presented with a ring-enhancing lesion in the psoas muscle, initially suspected as an abscess.
- MRI and CT-guided biopsy confirmed the lesion was a sequestered disc herniation, not an infection or tumor.
- The case underscores the importance of considering sequestered disc herniation in psoas muscle mass differential diagnoses.

## Abstract

We present a rare case of a sequestered lumbar disc herniation mimicking a psoas abscess. A 68-year-old male with a history of tongue cancer surgery had a ring-enhancing lesion in the left psoas muscle at the L2/3 level on contrast-enhanced computed tomography (CT), raising concerns about psoas abscesses related to vertebral spondylodiscitis. Magnetic resonance imaging (MRI) revealed a well-defined mass with low signal intensity on T1-weighted images, high signal intensity on T2-weighted images, and surrounding muscle edema. CT-guided biopsy revealed degenerative intervertebral disc tissue without malignancy or acute inflammation, confirming a sequestered disc herniation as the cause. Sequestered disc herniation is a rare condition in which the disc material migrates away from its origin, presenting similarly to infections or tumors. Imaging features such as ring enhancement in contrast studies can complicate the diagnosis. This case highlights the importance of considering sequestered disc herniation in the differential diagnosis of psoas muscle masses. Further research is needed to better understand the pathophysiology and management of sequestered disc herniation in the psoas muscle.