Giant Lumbosacral Tarlov Cyst With Extensive Presacral Extension: A Case Report And Review Of Literature
Published 2025-04-15
Keywords
- Tarlov cyst, perineural cyst, lumbosacral spine, MRI, presacral lesion, conservative management.
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Abstract
Background: Tarlov cysts, or perineural cysts, are rare cerebrospinal fluid (CSF)-filled lesions most often found in the sacral region. Although frequently incidental, large or multiloculated cysts can cause mass effect or neurological symptoms. Recent analyses describe symptomatology and interventional decision-making in symptomatic cases.
Case Presentation: A 42-year-old male presented with a one-year history of dysuria and urinary frequency, followed by acute low back pain. CT imaging revealed large bilateral perisacral multiloculated cystic lesions with spinal canal extension. MRI confirmed a giant lumbosacral Tarlov cyst (11 × 9 cm) with multiple lumbar perineural cysts. The patient remained neurologically intact and was managed conservatively. Follow-up MRI after seven months showed stable cyst morphology without new findings. Recent case reports support effectiveness of tailored non-operative management in select patients.
Conclusion: This case highlights the imaging features and natural course of a lumbosacral Tarlov cyst managed conservatively, emphasizing the importance of individualized management guided by clinical presentation and neurological findings.