Cervical disc, mimicking nerve sheath tumor, with rapid spontaneous recovery: a case report

Abstract

The study design includes a case report and clinical discussion. The potential of acute disc herniations to regress spontaneously has been previously reported. However, the initial radiological presentation can be misleading, leading to therapeutic pitfalls, especially when the presence of myelopathy calls for early intervention. We present the case of a 46-year-old woman with a cervical intraspinal enhancing mass, associated enhancement of the C6 root and myelopathy, leading to the presumptive diagnosis of a nerve sheath tumor. The patient was offered surgery, which she denied. The patient returned 7 weeks later with significant clinical improvement. A subsequent magnetic resonance imaging depicted a herniated cervical disc and regression of myelopathy. Although spontaneous regression of disc prolapse and myelopathy have been previously reported, the initial radiological presentation and the short period of regression in this case highlight the need for a thorough understanding of the natural course of cervical disc herniations. Nonsurgical conservative observation should be considered an option for treatment for some cervical disc herniations that are likely to regress for very specific and predictable reasons.