Presentation
Worsening low back pain for past one year without neurological deficit. Background history of chronic anemia on regular blood transfusion.
Patient Data
Echogenic solid mass at the presacral region within the pelvis.
No significant internal vascularity on color Doppler.
Large well-defined presacral mass showing heterogeneous signal intensities on both T1WI and T2WI. The signal intensities of this mass are similar to signal intensities of bone marrow in adjacent vertebrae. Minimal post-contrast enhancement.
The vertebrae have coarse trabeculation and heterogeneous signal intensities, as do the pelvic bones included in the study.
Desiccation of the lower lumbar intervertebral discs. No disc bulge or herniation.
Case Discussion
Known case of Beta thalassemia major, the well-defined presacral mass arising from the sacral bone appears to be due to extramedullary hematopoiesis. This mass shows minimal enhancement post gadolinium administration and has similar signal intensities to the bone marrow of adjacent vertebrae.
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