Intradural extramedullary primary hydatid cyst of the spine: a case report and review of literature

Abstract

Primary intradural extramedullary hydatid cyst is a rare form of parasitic infection, causing focal neurological signs, commonly observed in sheep-raising areas of the world. We report a rare case of intradural, extramedullary spinal cyst, which we had misdiagnosis in the first surgery, because of rarity of the case. A 55-year-old man presented to our hospital in August 2008. He was admitted to our clinic because of lumbar pain of increasing severity and progressive difficulty with walking and stiffness of both lower limbs, which had lasted for 1 month. On the basis of imaging results, arachnoid cyst of the lumbar spine was diagnosed. Due to rapid progression of the patient’s symptoms toward spastic paraplegia, he underwent an emergency surgical decompression procedure. The patient underwent exploratory surgery using a posterior approach. A L1–L2 laminectomy was performed. After opening the dura, an intradural extramedullary cystic mass was determined. The surgical specimen measured 6 × 2 cm and was described as a whitish, pearl-like, semitranslucent, cystic material, which was thought to be parasitic. Surgery has to be followed by albendazole therapy.

A Hydatid Cyst of the Lumbar Spine: A Rare Cause of Paraplegia

“…The present case was a multiple intradural extramedullary type, which presented at younger age. Similar cases of intradural extramedullary spinal hydatidosis have been also discussed by M. Ahmad et al, Lotfinia I et al, and Senol N. et al (7)(8)(9).…”

A rare parasitic infection: primary intradural extramedullary hydatid cyst

“…Hydatid cysts are a rare parasitic infection, caused by the larval form of Taenia or Echinococcus granulosus, which are typically found in young patients of both genders (11).…”

Answer to the Letter to the Editor of F.-A. Dauchy et al. concerning manuscript “Intradural extramedullary primary hydatid cyst of the spine: a case report and review of literature”. Eur Spine J, doi:10.1007/s00586-012-2373-1 by I. Lotfinia, S. Sayyahmelli, A. Mahdkhah, M. Shoja M (2012)

“…Rupture occurs most frequently in spinal hydatidosis with bone involvement, because the cysts are contained in narrow spaces within bone boundaries, making removal particularly difficult [7]. In these cases, the possibility of retain and rupture is high, but the cysts of soft tissues and extra osseous lesions are usually unilocular with thicker cystic walls and spherical shape due to the lack of resistance from the hard bone tissue during their growth [1] such as our case [22]. As a result, it is easier to remove in intact forms and the rate of recurrence will be lower.…”

“…As a result, it is easier to remove in intact forms and the rate of recurrence will be lower. Recurrence was reported in 28 (17.8 %) cases from 45 intradural extramedullary hydatid cysts [22]. Because of short time of study and unmentioned recurrence in 17 cases, the real rate may be even more.…”