Case of the Week
Section Editors: Matylda Machnowska1 and Anvita Pauranik2
1University of Toronto, Toronto, Ontario, Canada
2BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
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March 22, 2018
Spinal Hydatid Cyst
- Background:
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Hydatid disease is caused by the cystic (larval) stage of the Echinococcus tapeworm species.
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Spinal involvement is rare, with an incidence of about 1%.
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- Clinical Presentation:
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Patients present with radiculopathy, myelopathy, and/or local pain owing to bony destructive lesions, pathologic fracture, and consequent cord compression.
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- Key Diagnostic Features:
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Nonenhancing/minimally enhancing extradural multicystic lesion centered in the vertebral body or posterior elements with associated extension to the spinal canal or paraspinal soft tissues
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- Differential Diagnoses:
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Benign or malignant bone lesions: aneurysmal bone cyst, giant cell tumor, osteosarcoma, chondrosarcoma, chordoma, metastasis
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Extradural meningeal cysts: arachnoid cyst, neurenteric cyst, cysticercosis
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Cystic nerve sheath tumor
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- Treatment:
- Surgical removal of the hydatid cyst without intraoperative rupture due to potential anaphylaxis from cyst fluid
- Perioperative and longer term antihelminthic treatment
- Monitoring for disease recurrence
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