[Bone echinococcosis]

Hydatidosis of the bone is a rare form of human echinococcosis. Due to the clinical, diagnostic, therapeutic and prognostic problems involved, the costal and occipital locations are of particular interest. Both are rare and differ from visceral locations in that they are always "primary" and have the capacity to destroy the bone matrix and infiltrate the adjacent tissues. The course of the disease is particularly slow and without specific signs and symptoms so that it can look like any bone condition. Laboratory tests are frequently negative and not wholly specific. While some authors claim that the radiological picture is of no diagnostic significance, others state that it offers pathognomonic signs. Diagnosis will be obtained through the combined assessment of clinical, radiological, laboratory and anamnestic data. Provenance from a rural area should reinforce the suspicion. Surgery, whether radical or conservative, is the key factor in treatment though local recurrences are common. Better results are obtained by combining surgery with Mebendazole for pre and postoperative prophylaxis. Large doses over a long period will give a better clinical course and reduce the incidence of recurrences. The prognosis is good for both sites as long as surgical treatment is given in good time.