{"id":"b0954f06-d91e-4290-ae4f-5b0b4639964e","slug":"giant-tarlov-cyst-presenting-as-pelvic-mass-often-doing-less-is-better","title":"Giant Tarlov Cyst presenting as pelvic mass: Often doing less is better","authors":["Abhishek Mehan","FNU Ruchika","Jitender Chaturvedi","Mohit Gupta","Tejas Venkataram","Nishant Goyal","Anil Kumar Sharma"],"abstract":"Background: Tarlov cysts are sacral perineural cysts arising between the peri and endoneurium of the posterior spinal nerve root at the Dorsal Root Ganglion and have a global prevalence rate of 4.27%. These are primarily asymptomatic (only 1% with symptoms) and typically arise in females between the ages of 50–60. Patients’ symptoms include radicular pain, sensory dysesthesias, urinary and/or bowel symptoms, and sexual dysfunction. Non-surgical management with lumbar cerebrospinal fluid drainage and computerized tomography-guided cyst aspiration typically provide only months of improvement before recurring. Surgical treatment includes a laminectomy, cyst, and/or nerve root decompression with fenestration of the cyst and/ or imbrication. Early surgery for large cysts provides the longest symptom-free periods. Case Description: A 30-year-old male presented with a very large magnetic resonance-documented Tarlov cyst (Nabors Type 2) arising from bilateral S2 nerve root sheaths with marked pelvic extension. Although he was initially treated with a S1, S2 laminectomy, closure of the dural defect, and excision/marsupialization of the cyst, he later required placement of a thecoperitoneal shunt (TP shunt). Conclusion: A 30-year-old male with large Nabors Type 2 Tarlov cyst arising from both S2 nerve root sheaths required a S1-S2 laminectomy, dural closure/marsupialization, and imbrication of the cyst, eventually followed by placement of a TP shunt.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/b0954f06-d91e-4290-ae4f-5b0b4639964e/featured/hero-1781560423492.png","publishDate":"2023-03-24T00:00:00.000Z","doi":"10.25259/SNI_79_2023","categories":["Spine","Case Report"],"fullTextUrl":"https://surgicalneurologyint.com/api/articles/b0954f06-d91e-4290-ae4f-5b0b4639964e/pdf"}