Unusual cause of acute sciatica

This 32-year-old-man was admitted to the emergency department because of S1 left acute sciatica. An emergency, CT-scan showed highly probable appearance of herniated disc in L5-S1 level (A). The patient was operated without founding disc herniation, but an aspect of anterior and posterior epidural abscess compressing the dural sheath at L5-S1. Medullary MRI showed after the up and the down extention of disease process (B). Histological examination of samples found a B lymphoblastic leukemia (C). The patient died 3 weeks after because of systemic infection. After review of literature, it was never been described that the sciatic pain can be a mode of revelation of B acute lymphoblastic leukemia. Only two cases reported this mode of revelation but for lymphoma requiring a surgical intervention -as our case- firstly to relieve the patient by a radicular decompression and secondly for histological diagnosis.