“Bunch of grapes” on the spine-spinal hydatidosis

Zhang, Zhicheng; Li, Fang; Guang-min, Zhao; Sun, Tiansheng

doi:10.1016/s1413-8670(12)70335-5

Cited by 2 publications

(4 citation statements)

References 3 publications

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“…T2 images often show hyperintense cysts with clear boundaries that are rounded or oval in shape and flow together, while cyst septations produce “wheel-like” structures, and the presence of daughter cysts is indicated by “rosette-like” or honeycomb-like” structures[ 2 , 10 - 12 ]. Spinal cystic echinococcosis has a characteristic appearance of images resembling a bunch of grapes (Figure 2 )[ 4 , 13 ]. In the typical MRI findings of this patient, would not difficult for a physician with experience in the diagnosis and treatment of hydatid disease to make a preliminary diagnosis of spinal hydatidosis.…”

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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“… 25 , 27 , 43 , 44 , 46 , 47 , 62 , 69 – 75 Multiple osteolytic lesions resemble a bunch of grapes and contain trabeculae with cortical thinning and calcification of neighbouring soft tissues. 27 , 71 In most cases, the intervertebral disc is not affected, but the cartilage may be flattened or distorted by a vertebral fracture. Radiographic imaging of zones of multilocular osteolysis with a hazy image of the bone, without periosteal or osteophytic reaction and without process of condensation is a highly suggestive finding of echinococcosis.…”

Section: Diagnosismentioning

confidence: 99%

“…MRI provides higher contrast between different types of soft tissues and can be displayed in any plane besides the three classical planes used in CT. MRI findings include multiple cystic fluid-filled lesions, septated with thin walls and irregular branching resembling a bunch of grapes at multiple levels; paravertebral muscles show multiple large, spherical, cystic lesions with smaller cysts inside. 20 , 46 , 47 , 62 , 70 , 71 , 73 , 74 , 77 – 80 The signal intensity of hydatid cysts is hypointense on T1-weighted MRI and hyperintense on T2-weighted MRI. 20 , 62 , 70 , 73 , 74 , 77 – 80 Multilocular cysts may represent daughter cysts; these are small spheres that contain protoscolices and are formed from the inner layer of the hydatid cyst.…”

Section: Diagnosismentioning

confidence: 99%

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Echinococcosis of the spine

et al. 2021

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Echinococcosis or hydatid disease affecting the spine is an uncommon manifestation of Echinococcus granulosus infection of the spine. More commonly found in endemic areas, it causes significant morbidity and mortality as it grows slowly and produces symptoms mainly by compressing the spinal cord. As diagnostic methods are non-specific, diagnosis and management are usually delayed until the disease is advanced, thereby therapy is usually unlikely. Treatment is usually surgical, aiming at cyst excision, spinal cord decompression and spinal stabilization. This article summarizes the clinical findings of echinococcosis of the spine, discusses the specific laboratory and diagnostic findings, lists the current treatment options, and reviews the patients’ outcomes. The aim is to prompt clinicians to be aware of the possibility of echinococcosis as a possible diagnosis in endemic areas. Cite this article: EFORT Open Rev 2021;6:288-296. DOI: 10.1302/2058-5241.6.200130

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“Bunch of grapes” on the spine-spinal hydatidosis

Cited by 2 publications

References 3 publications

Incurable and refractory spinal cystic echinococcosis: A case report

Incurable and refractory spinal cystic echinococcosis: A case report

Echinococcosis of the spine

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