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Primary sacral hydatid cyst. A case report.

Nayana Joshi1, Alejandro Hernandez-Martinez, Roberto Seijas-Vazquez

  • 1Hospital Universitari Vall d'Hebron, Departament de Cirurgia Ortopèdica y Traumatologia, Barcelona, Spain. njoshijubert@gmail.com

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|November 21, 2007
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Summary

This case report details a rare spinal hydatidosis case presenting as back pain and radiculopathy. Early examination of the pelvic cavity is crucial for diagnosing hidden hydatid disease causing neurological symptoms.

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Area of Science:

  • Medical Case Reports
  • Parasitology
  • Neurosurgery

Background:

  • Hydatidosis is a parasitic disease caused by Echinococcus tapeworms.
  • Osseous involvement, particularly in the spine, is rare but can lead to significant neurological deficits.
  • Early diagnosis is often challenging due to non-specific symptoms and rarity.

Observation:

  • A 59-year-old woman presented with progressive back pain, bilateral radiculopathy, spinal stenosis, and urinary incontinence.
  • Radiographs revealed an expansive lytic lesion in the pelvic bones with cortical destruction.
  • Positive serology for Echinococcus confirmed hydatid disease.

Findings:

  • The patient's neurological symptoms were attributed to an unusual osseous spinal presentation of hydatidosis.
  • Diagnosis was delayed due to initial lack of pelvic cavity examination and absence of visceral involvement.
  • CT and MRI studies were essential in characterizing the lesion and confirming the diagnosis.

Implications:

  • Highlights the importance of considering hydatid disease in the differential diagnosis of bone masses, especially in endemic areas.
  • Emphasizes the need for thorough examination, including pelvic cavity assessment, for patients presenting with sciatica, low back pain, or lower limb weakness.
  • Underscores the potential for delayed diagnosis and the impact of non-specific symptoms in osseous hydatidosis.