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Back bugged: A case of sacral hydatid cyst
1Department of Neurosurgery, Pramukh Neurosurgical Hospital, Ahmedabad - 380015, India.
Journal of Neurosciences in Rural Practice
|July 30, 2011
Summary
A rare sacral spinal canal hydatid cyst, initially misdiagnosed, caused persistent back pain and sciatica. Surgical excision and medication led to a full recovery, highlighting the need for re-evaluation of persistent sacral cystic lesions.
Area of Science:
- Neurosurgery
- Infectious Diseases
- Radiology
Background:
- Hydatid cysts in bone are rare, accounting for 0.5-2% of all hydatidoses.
- The thoracic spine is the most common site for spinal hydatid disease.
- Primary hydatid cysts in the sacral spinal canal are exceptionally uncommon.
Observation:
- A 23-year-old male presented with a five-year history of back pain and right-sided sciatica.
- Initial evaluation revealed a small S1 spinal canal cyst, presumed to be a Tarlov's cyst, with no treatment offered.
- Current MRI demonstrated a large, multiloculated cystic lesion from L5 to S2 with significant bone erosion.
Findings:
- Surgical intervention included L5 to S2 laminectomy and complete excision of the multiple cysts.
- The surgical cavity was irrigated with sterilized formalin, and a laparoscope confirmed complete excision and checked for pelvic extension.
- Postoperative treatment involved two months of albendazole, resulting in complete symptom resolution at 16 months follow-up.
Implications:
- This case underscores the rarity of sacral hydatid cysts and the potential for initial misdiagnosis.
- Persistent symptoms in patients with sacral cystic lesions warrant re-evaluation to rule out or confirm hydatid disease.
- Prompt diagnosis and surgical management, followed by appropriate medical therapy, are crucial for favorable outcomes in spinal hydatidosis.
