Dumbell hydatid disease of spine with posterior paraspinal muscle involvement

Abstract

Spinal hydatid disease is a rare form of hydatid disease caused by the larval form of Echinococcus granulosus (E. granulosus). Dogs are primarily the definitive hosts of E. granulosus with man and sheep serving as intermediate hosts. Spinal HD contributes to approximately 45 % of all skeletal hydatid disease cases. Spinal HD is perhaps the worst form of parasitic infestations associated with morbidity requiring surgical correction. Braithwaite and Lees have classified spinal hydatids into five types (1) intramedullary (2) intradural extramedullary (3) extradural intraspinal disease (4) vertebral hydatid (5) paravertebral hydatid. When hydatid disease from spinal canal extends into retroperitoneal space through the neural foramen, it gives dumbell formation (similar to nerve sheath tumors). Symptoms of hydatid are mainly due to compressive effects of the cyst, low back pain accompanying motor weakness, sensory disturbances, bowel and bladder disturbances and cauda equina syndrome. Extensive vertebral hydatidosis can cause fractures of vertebrae. Serology tests are used in diagnosing suspected cases of hydatid disease. MRI with soft tissue detail is more preferable than other modalities in diagnosing spinal hydatid. Successful treatment of spinal hydatid disease necessitates adequate neuroimaging evaluation, careful surgical removal without spillage of cystic components and adding adjuvant chemotherapy in few cases is the mainstay of treatment. Sometimes when it is difficult to retrieve all the cysts in toto, debulking is advised.

Primary vertebral echinococcosis: A case of mistaken identity

“…Braithwaite and Lees [5] had classified spinal hydatid as intramedullary, intradural extramedullary, extradural intraspinal, vertebral (most common), and paravertebral. When hydatid disease extends from the spinal canal through the neural foramen into the spinal canal, it is referred to as "dumbbell" formation or configuration [6].…”

Unusual occurrence of brain hydatid disease in a patient with previous surgical intervention for hemorrhagic venous infarct

“…The disease involves multiple organs and is more common in liver and rare in the central nervous system and soft tissues. MRI has been proved to be the best imaging modality for hydatid disease of the central nervous system [1,2,5,6]. There are two types of Echinococcus infections, of which Echinococcus granulosus is the most common and Echinococcus multilocularis is less common but more invasive.…”

“…There are two types of Echinococcus infections, of which Echinococcus granulosus is the most common and Echinococcus multilocularis is less common but more invasive. Dogs are definitive hosts whereas sheep are intermediate hosts [1,2,6,7]. Human beings are infected by intake of food or water contaminated by dog faces containing the parasite.…”

“…H ydatid disease is a parasitic disease, which is endemic in many parts of the world [1][2][3][4]. The prevalence of the disease varies and is more common in countries where cattle and sheep raising are practiced.…”

“…The imaging features depend on the stage of the disease, involved organ and associated complications [1]. The lesions have varied appearance ranging from cystic to solid appearing lesions.…”