Sacral hydatid cyst: illustrative case.

Area of Science:

• Medical Case Reports
• Parasitology
• Neurosurgery

Background:

• Echinococcus species cause hydatid cyst (HC) disease, typically affecting the liver and lungs.
• Skeletal involvement in HC disease is rare (0.5%-2%), with spinal HC occurring in half of these cases.
• Sacral spine involvement is exceptionally uncommon and presents diagnostic difficulties.

Purpose of the Study:

• To report a rare case of sacral hydatidosis.
• To highlight diagnostic challenges and management strategies for sacral HC disease.

Main Methods:

• A 17-year-old male with a history of HC disease presented with chronic low back pain, radiating leg pain, claudication, and constipation.
• Imaging revealed a large, multiloculated sacral cyst (S3-S5) involving the spinal canal and compressing the rectum.
• Diagnosis of sacral hydatidosis was confirmed, and the patient initiated albendazole therapy with planned surgical excision.

Main Results:

• A large sacral cyst causing spinal canal and rectal compression was identified.
• The patient experienced symptoms including low back pain and chronic constipation.
• Sacral erosion was noted on imaging.

Conclusions:

• Sacral hydatidosis should be considered in the differential diagnosis of low back pain and constipation, particularly in endemic areas.
• Early diagnosis, antiparasitic therapy (e.g., albendazole), and surgical intervention are vital due to the invasive nature and recurrence potential of HC disease.
• Close follow-up is essential to prevent complications, especially in atypical presentations like sacral involvement.