A case of sacral hydatid cyst

Abstract

INTRODUCTIONHydatid cyst of bone constitutes only 0.5-2% of all hydatidoses. The thoracic spine is the most common site of spinal hydatidoses. Primary hydatid cyst of the sacral spinal canal is rare.PRESENTATION OF CASEA 19-year-old man had cauda equina syndrome with pelvic pain 15 days ago, the pelvic radiography shows a lytic image depend on the left sacral wing. MRI showed an intra-pelvic cystic image invading the sacrum T1 hypointense and T2W hyperintense. The Hydatid serology was positive.Surgical treatment consisted of a wide drainage of hydatid cavity dug in the left sacral wing, and by which it communicated intra pelvic, with removal of the entire cyst by gentle aspiration, abundant rinsing with hypertonic saline, release and sacred roots encompassed in a puddle of fibrosis hydatid.The evolution was good with recovery of perineal sensation and anal tone. The sacroiliac joint was considered stable and did not require synthesis or reconstruction.DISCUSSIONHydatid cysts predominantly occur in liver and lungs. Involvement of other organs is uncommon. Neither surgery nor medical therapy is generally effective for bone, especially spinal hydatidosis. The initial treatment of choice is surgical excision for neural decompression and establishing diagnosis. Albendazole is the drug of choice against this disease, when suspected, presurgical use of Albendazole in Echinococcus infestations reduces risk of recurrence and/or facilitates surgery by reducing intracystic pressure.CONCLUSIONA missed diagnosis of hydatid cyst could be devastating. Hence, hydatid cyst should be kept as a differential diagnosis, when encountered with a cystic lesion of sacrum. In addition, longterm follow-up is mandatory as recurrence is high despite use scolicidal agents.

Adolescente con inestabilidad lumbosacra por presencia de quiste hidatídico: reporte de caso

“…La hidatidosis sacra es una entidad rara (5,7) ; así, en un estudio de 25 casos de hidatidosis espinal solo se encontraron seis casos que afectaban al hueso sacro (8) , es por ello que nuestro caso es interesante y nos llevó a plantear diagnósticos diferenciales. Aun más raro fue que presentó inestabilidad lumbosacra ocasionada por la laterolistesis.…”

“…El tratamiento quirúrgico consta de la descompresión (laminectomía y/o facetectomía), exéresis de los quistes, liberación del canal espinal y estabilización (fijación transpedicular) (8,10,15) . A pesar del tratamiento quirúrgico, la enfermedad con frecuencia recae con destrucción progresiva de la columna vertebral y deterioro neurológico (15) .…”

“…La hidatidosis vertebral ocurre entre el 0,5 y 2% de todos los casos y corresponde al 50% de todas las hidatidosis musculoesqueléticas; es seguida, en frecuencia, por otras localizaciones como la pelvis y huesos largos (7,12) . Estas lesiones se localizan en la región dorsal (52%), lumbar (37%) y cervical -sacra (11%) (7,8) , siendo la columna sacra una ubicación rara (8,9) . Presentamos el caso de un paciente con quiste hidatídico localizado en región lumbosacra, cuya manifestación clínica fue el síndrome de cauda equina e inestabilidad lumbosacra.…”

Musculoskeletal Hydatid Cysts Resembling Tumors: A Report of Five Cases

“…There is a consensus that a combination of surgical and medical approaches is optimal; however, there is still disagreement about the details 13,[19][20][21][22][23][24][25][26][27][28] . Surgery mainly comprises resection of infected tissue 5,[22][23][24][25][26] .…”

Rekürren Primer Spinal Kist Hidatik

“…Kist hidatik tarım ve hayvancılığın sık olarak yapıldığı bölgelerde ve toplumlarda hijyen ve koruyucu hekimlik önlemlerinin yetersiz kalması sonucu görülebilen, echinococcus granulosus larvasının yol açtığı önemli paraziter bir enfeksiyondur 1,2 . Enfeksiyon insanlara konakçı hayvanlarla doğrudan temas (köpek,kurt) ya da enfekte gıdaların sindirilerek vücuda alınması sonucu girer 3,4 .…”