Of Cestodes and Men: Surgical Treatment of a Spinal Hydatid Cyst

Saul, Dominik; Seitz, Mark-Tilmann; Weiser, Lukas; Oberthür, Swantje; Roch, Jonathan; Bremmer, Felix; Perske, Christina; Viezens, Lennart; Sehmisch, Stephan; Lehmann, Wolfgang

doi:10.1055/s-0039-1693707

Cited by 6 publications

(3 citation statements)

References 21 publications

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“…Therefore, in the initial diagnosis of spinal tuberculosis or spinal pyogenic infection, according to the patient’s clinical symptoms and signs, a differential diagnosis should consider spinal hydatidosis, malignancies, giant cell tumors of bone, etc. [ 8 , 9 ]. The overall incidence of spinal hydatidosis is very low, and it is more likely to be misdiagnosed and missed.…”

Section: Discussionmentioning

confidence: 99%

Incurable and refractory spinal cystic echinococcosis: A case report

Zhang¹,

Ma²,

Liu³

et al. 2021

WJCC

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BACKGROUND Although the incidence and cure rate of spinal hydatidosis are low, the recurrence rate of spinal hydatidosis is high, and the prognosis of spinal hydatidosis is poor. Therefore, we report a typical case of refractory spinal hydatidosis to increase spine surgeons’ awareness of the disease and reduce misdiagnosis and recurrence. CASE SUMMARY A 48-year-old man presented with back pain, significant weight loss, and paralysis of both lower limbs. The patient was misdiagnosed with spinal tuberculosis in an outside hospital. However, spinal magnetic resonance imaging (MRI) showed hyperintense cystic components on T2-weighted images and hypointensity on T1-weighted images. A lobulated, multiocular, honeycomb-appearance, septated cystic mass protruding intraspinally and compressing the spinal cord at segments T8–T9 was present. Paravertebral polycystic lobular lesions presented as a “bunch of grapes”. The ELISA test result for Echinococcus granulosus was positive. Then, a diagnosis of spinal hydatidosis and lung hydatid disease was made, and the patient underwent left transthoracic approach lobectomy, paravertebral lesion debridement, and subtotal vertebrectomy with vertebral body replacement of segments T8 and T9 by a mesh cage. The patient also underwent albendazole chemotherapy before and after surgery. One year after stopping the drug therapy, the patient developed recurrent T5 vertebral lesions and underwent a second subtotal vertebrectomy surgery. The patient is currently in good condition and is receiving long-term medication and follow-up. CONCLUSION The MRI feature of a “bunch of grapes” is a typical imaging indication of spinal hydatidosis. Subtotal vertebrectomy is a risk factor for postoperative recurrence. Total spondylectomy makes it possible to cure spinal hydatidosis, but antiparasitic drug therapy is also an important supplementary therapy to multimodal therapy. It is preferable for patients with spinal hydatidosis to receive life-long antiparasitic medication therapy and follow-up.

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Section: Discussionmentioning

confidence: 99%

Incurable and refractory spinal cystic echinococcosis: A case report

Zhang¹,

Ma²,

Liu³

et al. 2021

WJCC

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“…Cervical and thoracic vertebrae (Bouattour et al, 2021;Cavus et al, 2018) Decompression; resection of cyst lesion; washing with 20% hypertonic saline solution ABZ (15 mg/kg/d, po. For 1 year) No recurrence after 1 year Thoracic vertebrae (Zhang et al, 2017Akhaddar and Boucetta, 2018;Dighe et al, 2018;Depré et al, 2019;Saul et al, 2020;Das et al, 2021;Safari et al, 2021;Alkan Çeviker et al, 2022) Resection of cyst lesion; ashing with betadine solution and hypertonic saline ABZ (20 mg/kg/day for 6 months) Improved…”

Section: Surgerymentioning

confidence: 99%

Progress of research on the diagnosis and treatment of bone cystic echinococcosis

Meng,

Ren,

Xiao

et al. 2023

Front. Microbiol.

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Bone cystic echinococcosis (CE) is one of the most complex and dangerous of all echinococcoses. The lack of typical imaging features and clinical manifestations makes diagnosis and treatment of this disease difficult. X-ray and computed tomography (CT) images of bone CE are similar to those of bone cysts, giant-cell bone tumors, and bone metastases, but magnetic resonance imaging (MRI) shows good diagnostic value due to excellent soft-tissue imaging features. Serological tests cannot be used as a definitive diagnostic method for bone CE due to cross-reactivity, which can lead to false-positive or false-negative results. The development of novel antigens can open new frontiers in the diagnosis of the disease. Currently, views conflict on how to diagnose and treat bone CE. Both surgical and pharmacological treatments can be used, but determining which is appropriate is difficult due to the different sites and clinical manifestations of bone CE. Radical resection is not indicated for large-bone injuries, and Pharmacotherapy becomes important. This article reviews the progress of research into the pathogenesis and clinical manifestations of, and diagnostic strategies and treatment options for, bone CE. We aimed to provide a reference for clinical diagnosis and -treatment options.

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“…Human hydatid disease is a zoonotic disease transmitted from animals to humans, which is caused mainly by tapeworm parasites of the genus Echinococcus (Agudelo et al, 2016;Eckert et al, 2004;Hanifian et al, 2013;Romig et al, 2017a). While parasitic infections are more prevalent in developing countries and areas with poor sanitation in the world, cases are also presented in developed regions (Belhassen-Garcia et al, 2011a;Gezercan et al, 2017a;Neumayr et al, 2013a;Saul et al, 2020;Sioutis et al, 2021a). Higher incidence rates have been reported in temperate countries, such as North Africa, southern Russia, Central Asia, and western China, as well as Australia and South America (Gottstein et al, 2015;Grosso et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

Multiple debridement of cavity lesions combined with antiparasitic chemotherapy in the treatment of mid or advanced spinal echinococcosis: a retrospective study of 33 patients

Luan

Deng

et al. 2022

International Journal of Infectious Diseases

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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Of Cestodes and Men: Surgical Treatment of a Spinal Hydatid Cyst

Cited by 6 publications

References 21 publications

Incurable and refractory spinal cystic echinococcosis: A case report

Incurable and refractory spinal cystic echinococcosis: A case report

Progress of research on the diagnosis and treatment of bone cystic echinococcosis

Multiple debridement of cavity lesions combined with antiparasitic chemotherapy in the treatment of mid or advanced spinal echinococcosis: a retrospective study of 33 patients

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