-
Joint Bone Spine Mar 2022
Topics: Humans; Ovarian Neoplasms; Tarlov Cysts
PubMed: 34740729
DOI: 10.1016/j.jbspin.2021.105307 -
The Journal of Spinal Cord Medicine 2009Tarlov cysts or spinal perineurial cysts are uncommon lesions. These are mostly incidental findings on magnetic resonance imaging or myelograms. The objectives of this... (Review)
Review
BACKGROUND/OBJECTIVE
Tarlov cysts or spinal perineurial cysts are uncommon lesions. These are mostly incidental findings on magnetic resonance imaging or myelograms. The objectives of this study were to describe Tarlov cysts of the sacral region as a potential cause for retrograde ejaculations and review available management options.
METHODS
Case report and literature review.
RESULTS
A 28-year-old man presented with back pain and retrograde ejaculations resulting in infertility. After microsurgical excision of large perineurial cysts, back pain resolved, but semen quality showed only marginal improvement. Later, the couple successfully conceived by intrauterine insemination. To the best of our knowledge, this is the first reported case of Tarlov cyst associated with retrograde ejaculation and infertility.
CONCLUSIONS
Despite being mostly asymptomatic and an incidental finding, Tarlov cyst is an important clinical entity because of its tendency to increase in size with time. Tarlov cysts of the sacral and cauda equina region may be a rare underlying cause in otherwise unexplained retrograde ejaculations and infertility. Microsurgical excision may be a good option in a select group of patients.
Topics: Adult; Humans; Infertility, Male; Laminectomy; Magnetic Resonance Imaging; Male; Microsurgery; Tarlov Cysts
PubMed: 19569467
DOI: 10.1080/10790268.2009.11760771 -
Neurocirugia (English Edition) 2023Tarlov cysts are a common finding in MRI. Most of them are asymptomatic but in some cases can cause pain in urogenital region. Diagnosis and treatment are controversial... (Review)
Review
Tarlov cysts are a common finding in MRI. Most of them are asymptomatic but in some cases can cause pain in urogenital region. Diagnosis and treatment are controversial and most of the symptomatic cases are not well diagnosed and treated because of unawareness of neurosurgeons about them. Treatment of symptomatic TC is effective and good results have been published with percutaneous and surgical techniques. A case of a young woman with a symptomatic sacral cyst treated surgically successfully is presented and literature about it is reviewed.
Topics: Female; Humans; Tarlov Cysts; Pain; Laminectomy; Microsurgery; Sacrum
PubMed: 36754756
DOI: 10.1016/j.neucie.2022.11.021 -
World Neurosurgery Feb 2018A presacral Tarlov cyst is an unusual cause of abdominal pain. The unusual location of a presacral Tarlov cyst can lead to misdiagnosis and inappropriate treatment. To... (Review)
Review
BACKGROUND
A presacral Tarlov cyst is an unusual cause of abdominal pain. The unusual location of a presacral Tarlov cyst can lead to misdiagnosis and inappropriate treatment. To guide appropriate diagnosis and treatment, we reviewed causes, clinical presentations, radiologic features, and management options of this extremely rare lesion.
METHODS
We performed an English-language literature search using PubMed to identify reports of patients with presacral Tarlov cysts. The diagnosis was based on classic radiologic signs. Seven patients described in 7 publications met the inclusion criteria and were analyzed in conjunction with 3 new patients described by our team.
RESULTS
A congenital arachnoidal defect may be the primary causative factor of a presacral Tarlov cyst. Lumbosacral pain, leg pain, and bowel and bladder dysfunction are common clinical complaints, while abdominal pain is uncommon. Myelography and magnetic resonance imaging are considered useful diagnostic techniques. Myelography provided the definitive diagnosis for 33% of the patients, and magnetic resonance imaging was diagnostic for 67%. Surgical interventions may be appropriate for symptomatic presacral lesions. Two patients who received conservative treatment continued to experience their presenting symptoms, whereas 7 patients who underwent surgical treatment experienced favorable outcomes.
CONCLUSIONS
Although extremely rare, presacral Tarlov cysts should be suspected in patients with abdominal pain, especially when pain occurs along with other neurologic symptoms. This review provides a systematic description of this rare disease, which may be helpful in guiding the appropriate diagnosis and treatment.
Topics: Abdominal Pain; Adult; Female; Humans; Magnetic Resonance Imaging; Microsurgery; Myelography; Tarlov Cysts
PubMed: 29102753
DOI: 10.1016/j.wneu.2017.10.135 -
World Neurosurgery Mar 2019We report an 8-month-old female infant with complaints of irritability and recent inability to sit in a stable position. On physical examination, a palpable mass in the...
We report an 8-month-old female infant with complaints of irritability and recent inability to sit in a stable position. On physical examination, a palpable mass in the left upper quadrant of her abdomen was evident. Sonography and magnetic resonance imaging showed a giant cyst, consisting of 2 communicating compartments: dorsal and ventrolateral. The dorsal part compressed the conus medullaris, and the ventrolateral part compressed the left kidney. Partial cyst wall resection and imbrication for the dorsal pouch were done, and diagnosis of Tarlov cyst was confirmed via the visualization of the endocystic nerve root during surgery. Familiarizing physicians with this unusual presentation of Tarlov cyst may help them in early recognition of this lesion, and subsequent surgery might be considered to prevent clinical sequela. To our knowledge, a lumbar Tarlov cyst presenting as a giant abdominal cyst in an infant has not been reported in the English-language literature.
Topics: Female; Humans; Infant; Magnetic Resonance Imaging; Neurosurgical Procedures; Tarlov Cysts; Tomography, X-Ray Computed; Ultrasonography
PubMed: 30576828
DOI: 10.1016/j.wneu.2018.12.009 -
World Neurosurgery Jun 2019Giant Tarlov cysts are always symptomatic and mimic many serious pathologic entities. We present the largest, to our knowledge, reported Tarlov cyst. (Review)
Review
BACKGROUND
Giant Tarlov cysts are always symptomatic and mimic many serious pathologic entities. We present the largest, to our knowledge, reported Tarlov cyst.
CASE DESCRIPTION
A 33-year-old woman with Marfan syndrome suffered from right kidney hydronephrosis because of ureter obstruction, for which she was treated with nephrostomy. Her neurologic examination was unremarkable. The role of magnetic resonance imaging in the management of this case is described. Absence of intractranial hypotension symptoms after cerebrospinal fluid (CSF) overdrainage suggested the presence of a valve-like mechanism. The patient was planned for surgical cyst remodeling by the application of titanium clips. The cyst's neck was exposed through an L5-S2 laminectomy. L5 and S1 laminae were severely eroded. CSF leaked out of the underlying, bulging, and thinned dura at each attempt for clip application. Intraoperatively, multiple responses from the S1, S2, and S3 roots were simultaneously recorded at each stimulation. Therefore, we decided to abandon this technique and performed a nonwatertight duroplasty followed by a layered wound closure instead. A week later, the patient received a lumbar-peritoneal shunt. The patient remained neurologically intact, the cyst shrunk, and the nephrostomy was removed.
CONCLUSIONS
Indirect evidence was helpful to assess for the presence of a valve-like mechanism. Intraoperatively, the surgeon must keep on high alert for sacral erosion to avoid inadvertent dural tear and rootlet injury. Finally, lumboperitoneal diversion remains a valid alternative in the management of our giant Tarlov cyst because it reduced the intracystic pressure that resulted in cyst regression.
Topics: Adult; Evoked Potentials, Motor; Female; Humans; Hydronephrosis; Lumbosacral Plexus; Magnetic Resonance Imaging; Marfan Syndrome; Nephrostomy, Percutaneous; Symptom Assessment; Tarlov Cysts; Tomography, X-Ray Computed; Ureteral Obstruction; Wound Closure Techniques
PubMed: 30880195
DOI: 10.1016/j.wneu.2019.02.222 -
Rehabilitacion 2020Tarlov, or perineural cysts, are lesions of the nerve root usually located at the sacral level of the spine. Their cause is unclear. These cysts are generally identified... (Review)
Review
Tarlov, or perineural cysts, are lesions of the nerve root usually located at the sacral level of the spine. Their cause is unclear. These cysts are generally identified as an incidental finding and are usually asymptomatic. Symptomatic cysts are infrequent, with symptoms usually consisting of pain, radiculopathy and, less frequently, bladder, bowel and sexual dysfunction. We report the case of a 70-year-old woman with Tarlov cyst, provoking faecal incontinence, and review the aetiology, pathophysiology and management of this particular case.
Topics: Aged; Anal Canal; Electromyography; Fecal Incontinence; Female; Humans; Lumbar Vertebrae; Magnetic Resonance Imaging; Manometry; Nerve Compression Syndromes; Pudendal Nerve; Spinal Stenosis; Tarlov Cysts
PubMed: 32441263
DOI: 10.1016/j.rh.2019.07.005 -
BMJ Case Reports Mar 2019A 65-year-old patient presenting with left labial and perirectal pain was diagnosed with bilateral Tarlov cysts. Upon treatment of the left Tarlov cyst (the right was...
A 65-year-old patient presenting with left labial and perirectal pain was diagnosed with bilateral Tarlov cysts. Upon treatment of the left Tarlov cyst (the right was asymptomatic) using image-guided aspiration and subsequent injection of the cyst with fibrin sealant, the cyst reduced in size. To our knowledge, there are currently no other documented cases in which the Tarlov cyst reduced in size following this procedure. This case would seem to suggest that clinicians are poorly informed with regard to Tarlov cysts. These cysts are more common in Caucasian women, many of whom are told their cysts are not responsible for their pain or that they are not treatable. However, there is clear evidence that some Tarlov cysts are symptomatic and minimally invasive procedures have been developed to treat them. As they primarily occur in women, it is possible gender bias may also play a role in the delayed diagnosis of the patient's pain.
Topics: Aged; Female; Fibrin Tissue Adhesive; Humans; Paracentesis; Tarlov Cysts; Tissue Adhesives; Treatment Outcome
PubMed: 30852497
DOI: 10.1136/bcr-2018-227256 -
International Journal of Surgery Case... 2017Tarlov cysts were first described in 1938 as an incidental finding at autopsy. The cysts are usually diagnosed on MRI, which reveals the lesion arising from the sacral...
Tarlov cysts were first described in 1938 as an incidental finding at autopsy. The cysts are usually diagnosed on MRI, which reveals the lesion arising from the sacral nerve root near the dorsal root ganglion. Symptomatic sacral perineural cysts are uncommon and it is recommended to consider Tarlov cyst as a diagnostic of exclusion. We report a case of a patient with voluminous bilateral L5 and S1 Tarlov cyst, and right hip osteonecrosis to increase the awareness in the orthopaedic community. A 57-year-old female, in good health, with chronic low back pain since 20 years, presented suddenly right buttock pain, right inguinal fold pain and low back pain for two months, with inability to walk and to sit down. X-ray of the lumbo-sacral spine revealed asymmetric discopathy L5-S1 and L3-L4. X-ray of the right hip did not reveal anything. We asked for an MRI of the spine and it revealed a voluminous fluid-filled cystic lesion, arising from the first sacral nerve root on both side and measuring 3,3cm in diameter. The MRI also show a part of the hip and incidentally we discovered an osteonecrosis Ficat 3 of the right femoral head. The patient was taken for a total hip arthroplasty, by anterior approach. Patient appreciated relief of pain immediately after the surgery. The current case show that even if we find a voluminous cyst we always have to eliminate other diagnosis (especially the frequent like osteonecrosis of the femoral head) and mostly in the case of unclear neurological perturbation.
PubMed: 28787671
DOI: 10.1016/j.ijscr.2017.07.045