Primary spinal extradural hydatid cyst: a rare cause of compressive neuropathy in a pediatric patient

Hydatid illness is caused by the parasite tapeworm Echinococcus. Spinal hydatid disease without visceral involvement is a rare condition. Symptoms of spinal hydatid disease are not specific and typically stem from spinal cord compression. Back pain is common, while radicular pain is observed in 25% to 95% of patients. Paraparesis is noted in 25% to 77% of individuals.

We present a case of an isolated spinal hydatid cyst in the lumbar spine in a 13-year-old girl presented with progressive bilateral lower limb paraparesis. The radiological, laboratory, and clinical findings were consistent with a diagnosis of brucellosis. However, the symptoms persisted despite treatment, and it was later revealed through surgery and pathological examination that the child had isolated hydatid cysts in the vertebrae.

While primary spinal hydatid cysts are rare, the incidence of these lesions might be higher if cases that resembled other cystic lesions on radiological scans but were conservatively managed, especially in endemic regions, are considered. When determining a surgical approach, it is important to consider hydatid disease as a possibility for certain bone cystic lesions.

Hydatid cysts should be considered in any child with a history of paralysis, especially if the child comes from an endemic area. In our case, the child was initially diagnosed with brucellosis, but it was later found that isolated hydatid cysts in the vertebrae caused the paralysis.