A sacral hydatid cyst mimicking an anterior sacral meningocele

Abstract

<jats:p>Hydatid disease is a zoonosis caused by <jats:italic>Echinococcus granulosus</jats:italic>. It is a progressive disease with serious morbidity risks. Sacral hydatid disease is very uncommon, accounting for &lt; 11% of spinal hydatidosis cases. The diagnosis of a sacral hydatid cyst is sometimes difficult because hydatidosis can simulate other cystic pathologies. The authors report on 9-year-old boy admitted to their service with a paraparesis that allowed walking without aid. The boy presented with a 2-year history of an evolving incomplete cauda equina syndrome as well as a soft cystic mass in the abdomen extending from the pelvis. Radiological examination revealed an anterior meningocele. A posterior approach with laminectomy from L-5 to S-3 was performed. Three lesions with classic features of a hydatid cyst were observed and removed. The diagnosis of hydatid cyst was confirmed histopathologically. Antihelmintic treatment with albendazole (15 mg/kg/day) was included in the postoperative treatment. The patient's condition improved after surgery, and he recovered normal mobility.</jats:p> <jats:p>The unusual site and presentation of hydatid disease in this patient clearly supports the consideration of spinal hydatid disease in the differential diagnosis for any mass in the body, especially in endemic areas.</jats:p>

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

“…dolor lumbar (85%), dolor radiculopático (25-95%), paraparesia (25-77%) y retención urinaria en pocos casos (12) . Nuestro paciente presentó dolor lumbar seguido de compromiso neurológico.…”

“…El tratamiento implica el abordaje quirúrgico y farmacológico, siendo este último administrado en el posoperatorio para controlar la enfermedad, evitar la diseminación sistémica y posible recurrencia (12) . 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) .…”

“…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) .…”

An Asymptomatic Large Anterior Sacral Meningocele in a Patient with a History of Gestation: A Case Report with Radiological Findings

“…These may include gastrointestinal and genitourinary tract tumors, dermoid and epidermoid cysts, aneurysmal bone cyst, hamartoma, intrasacral meningocele, hydatid cyst, lipoma, lymphangioma, perineurial cyst, rectal duplication, reproductive tract tumors, teratomas, and teratocarcinoma [4, 8]. Moreover, the most important finding in the differential diagnosis is to demonstrate the communication between the cystic lesion and subarachnoid space [6].…”

Anterior sacral Meningocele Associated with Tethered Cord Syndrome Presenting with Constipation: US, CT, MRI and X-Ray Findings

“…The disease is usually asymptomatic, but may turn symptomatic when the size of the mass starts to increase. In such occasions, urinary problems, dysmenorrhea, constipation, and even an ileus may develop [8]- [10]. It may be mistaken for other causes of a pelvic cystic mass, especially when the neck connecting the cyst with the thecal sac is narrow.…”