Thirty-four-year old female patient visited our clinic for posterior neck pain for 3 days. She had no medical history or traumatic injury. On physical examination, posterior neck pain aggravating with neck motion was seen, there was no neurologic symptom. WBC, ESR and CRP were slightly increased. There was no specific finding on simple cervical radiologic study but, on cervical CT, calcified lesion was seen on the right lateral side of dens. The symptom got better after medication with NSAIDs, oral and intra venous steroid drugs for 2 days, disappeared after 4 days with NSAIDs and intra venous steroid drug. In following lab study, inflammatory marker decreased. Crowned Dens Syndrome could be misdiagnosed with meningitis, so cervical CT study is essential for differential diagnosis. Symptoms can be treated with NSAIDs and steroid drug.

Far lateral lumbar disc herniation (FLLDH) is a rare type of intervertebral disc herniations based on its anatomical location. A herniated lesion compressing the exiting nerve root superiorly makes clinical symptoms of lumbar radiculopathy. We report a 77-year-old female patient presenting lower back pain, left buttock pain and numbness, radiating pain, tingling sensation on the left lower extremity. Radiological images revealed a 16.2x13.8x7.2 mm sized mass like lesion outside the left foraminal canal of the L5-S1 disc space, mimicking nerve sheath tumor at a extradural location. Histopathological examination of the specimen was confirmed as a sequestrated disc fragments. We conclude that preoperative careful evaluation should be exercised for the differential diagnosis of the extraforaminal soft mass.