Endoscopic evacuation of sacral hydatid cysts: case report

Açıkgöz, Bektaş; Sungur, Cem; Özgen, Tunçalp; Camurdanoglu, Mehmet; Berker, Mustafa

doi:10.1038/sc.1996.66

Cited by 15 publications

(17 citation statements)

References 9 publications

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“…Spinal hydatid cysts are usually situated in the dorsal region and generate medullary or radicular symptoms according to their location [1,3,6,13,14,18]. In the present case the hydatid cyst was extradural and located in the lumbar region.…”

Section: Case Reportmentioning

confidence: 51%

Primary spinal extradural hydatid cyst in a child: case report and review of the literature

Karadereler

Orakdogen

Kılıç

et al. 2002

European Spine Journal

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IntroductionHydatid disease is more common in young people who have had contact with dogs, wolves or cats [9,12]. In a large percentage of cases, echinococcus granulosus usually involves the liver and lungs.Hydatid disease of the bone is found in 1% of all cases, with the spine being involved in 45% of bone infestations. Disease usually spreads to the spine by direct extension from pulmonary, abdominal or pelvic infestation, and most commonly affects the dorsal region [2,9,11,12,20]. Primary spinal extradural hydatid cyst is extremely rare.A rare case of primary lumbar extradural hydatid cyst, which causes cauda equina compression, is reported and clinical presentation, diagnosis and surgical treatment are discussed. Case reportAn 8-year-old boy from Eastern Anatolia, who had not suffered from any other disease till then, presented with back pain, progressive weakness, numbness in both legs and difficulty in walking; all symptoms having appeared 7 months earlier.Physical examination showed no abnormality. Neurological examination revealed perianal hypoesthesia and paraparesis prominent on the right and distal muscle groups. There was loss of patella and Achilles reflexes, as well as urinary and anal incontinence.Abdominal ultrasonography scans and magnetic resonance (MR) images of the cranium and cervical region were normal. MRI of the lumbar region showed an intracanalicular cystic lesion with a regular contour and extradural location, with dimensions of 4.9 cm craniocaudally and 2.5 cm axially. There was cerebrospinal fluid-(CSF-) like signal intensity on T1-and T2-weighted images. The lesion had excessively compressed the dural sac and caudal roots and had expanded to the L3 and L4 neural foramina without any bone involvement (Fig. 1). Initially, the lesion was considered to be a hydatid cyst, but serological tests (specific ELISA/Western blot) proved negative.The case was explored with L2, L3, L4 laminectomy. The lesion was removed totally, with a fibrous pseudocapsule that tightly adhered to the dural sac and bone, and the cavity was irrigated with hypertonic saline. Histopathological examination revealed a hydatid cyst.Albendazole treatment was applied in the early postoperative stage. Paraparesis was improved almost completely in later controls extending over 3 years, and postoperative MRI scans showed that the hydatid cyst had been totally removed (Fig. 2). Anal incontinence was improved, while urinary incontinence persisted, but in a decreasing manner.Abstract Spinal hydatid cyst is a rare but serious condition. An 8-yearold boy presented with back pain, progressive weakness and numbness in both legs. Magnetic resonance imaging (MRI) of the lumbar region showed a cystic lesion with regular contour located in extradural space. There was cerebrospinal fluid-(CSF-) like signal intensity on T1-and T2-weighted images. The lesion had excessively compressed the dural sac and caudal roots, and expanded to the L3 and L4 neural foramina. The case was explored with L2, L3, L4 laminectomy and the hydatid cyst was r...

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Section: Case Reportmentioning

confidence: 51%

Primary spinal extradural hydatid cyst in a child: case report and review of the literature

Karadereler

Orakdogen

Kılıç

et al. 2002

European Spine Journal

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“…The information on this type of cyst was derived from 88 articles, 33 of which were published in national Turkish journals and 55 in international journals (Tables 1, 2) [1,2,3,4,5,6,7,10,11,13,14,16,17,18,19,21,22,23,25,26,27,29,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,52,53,54,55,56,57,58,59,…”

Section: Resultsmentioning

confidence: 99%

“…For diagnostic purposes, X-ray films were taken in all patients reported, CT scanning with/without myelography in 5 patients, and MRI in 7 patients. Extraneural involvement was present in only 3 patients, and a total of seven organs were affected (Table 6) [1,4,48]. Detailed information on lesion location was available for 18 of the patients reported (Table 8).…”

Section: Intraspinal Hydatid Cystsmentioning

confidence: 99%

Hydatidosis of central nervous system and its coverings in the pediatric and adolescent age groups in Turkey during the last century: a critical review of 137 cases

Turğut

2002

Child's Nervous System

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Despite the inherent limitations, this type of study indicates that the incidence of hydatidosis has not decreased in Turkey in recent years. The clinical findings were mostly atypical, and it was interesting that 4 patients were described as having cerebrovascular occlusive disease and 3 as having symptoms of movement disorders. Computed tomography and/or MRI techniques were extremely useful, both in reaching the correct diagnosis and for proper surgical management of hydatid disease, because of the absence of a pathognomonic clinical picture of this disease. The treatment of choice for hydatid disease of the CNS and its coverings was complete intact removal of the cyst. In contrast to that in intracranial hydatid cysts, however, surgical intervention was palliative, not curative, in almost all cases of intraspinal hydatidosis. According to this critical review of the literature, CNS hydatidosis is therefore still a life-threatening condition, in spite of all the advances in imaging techniques and therapeutic methods. The most important factors in prognosis are the localization of the focus of infection, rupture and of the cyst and dissemination of its content, and treatment modality. At present, surgical intervention preceded by careful neuroradiological evaluation remains the best surgical therapy, and this plus adjuvant chemotherapy is advocated in some cases as the gold standard for therapy.

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“…However, as the authors mentioned, there is no pathognomonic clinical picture of the disease [1]. It should be kept in mind as a rare cause of progressive myelopathy if the patient lives in the major sheep-raising areas of the world or if the patient has migrated from a region where it is endemic, as occurred in Normelli et al's case.…”

Section: Locationmentioning

confidence: 93%

“…In such cases, it is possible to use anterior and/or lateral decompression, but only with major tissue trauma. Alternatively, Açikgöz et al [1] have described an endoscopic surgical technique, a kind of minimal invasive procedure, for the removal of spinal lesions in an interesting case with multiple vertebral hydatid cysts.…”

Section: Surgical Treatmentmentioning

confidence: 99%