Hydatidosis of the pelvic bone: case report and review of the literature

Abstract

The authors report three cases of pelvic bone hydatidosis: two men and a woman aged from 25 to 42 years. The lesions were extensive: In two cases, they extended to the entire hemipelvis, and in one case, the extension was to the sacrum, which makes it difficult to carry out a radical surgery. In two cases, computed tomography was evocative and allowed for the completion of a local and precise checkup for a patient through MRI. At the therapeutic level, the first patient was treated by curettage and sterilization with oxygenated water followed by medical treatment, but with recurrence few months later. The second patient was put only under medical treatment because of the extent of the lesions, allowing therefore for clinical and radiological stabilization. Concerning the last patient, she benefitted from the resection of the femoral head and the right iliac wing followed by a medical treatment. The evolution was favorable with a three-year recession. The actual treatment of the osseous echinococcosis would be a combination of albendazole and surgery.

Lytic parasitic: a case of bone destructing echinococcosis

“… 1 , 6 Eventual bony destruction occurs through three pathological mechanisms, namely, 1 compression of the expansive cyst on surrounding tissue leads to pressure-induced bone atrophy, 2 obstruction of bone nutrient vessels leads to ischaemia and 3 osteoclast proliferation occurring around the site of bony compression. 9 – 12 …”

“… 1 , 6 The CT imaging may also assist with detecting cortical thinning and the presence of an underlying pathological fracture. 10 As with our case, extra- and endopelvic cystic collections can be seen with the use of CT. 12 The MRI can provide further imaging of soft tissue extension and bony lesions, specifically spinal involvement. 3 , 8 , 10 , 12 The MRI of the pelvis may show an expansive cystic lesion(s) causing destruction of the sacrum.…”

“… 10 As with our case, extra- and endopelvic cystic collections can be seen with the use of CT. 12 The MRI can provide further imaging of soft tissue extension and bony lesions, specifically spinal involvement. 3 , 8 , 10 , 12 The MRI of the pelvis may show an expansive cystic lesion(s) causing destruction of the sacrum. 6 A differential diagnosis of cystic lesions other than sacral hydatid disease include a schwannoma, meningocele, giant cell tumour or chordoma.…”

Primary Sacral Hydatid Cyst Mimicking a Neurogenic Tumor in Chronic Low Back Pain: Case Report and Review of the Literature

“…[24] On MR, benign schwannomas have smooth tumoral margins and are isointense with muscle on T1-weighted images and hyperintense on T2-weighted images. [25] In SHC, MR shows a cystic lesion with similar characteristics to cerebrospinal fluid with a thin peripheral enhancement after contrast administration. The sacral hydatid cyst (SHC) capsule is best seen on T2-and proton density-weighted images.…”

“…Other tests, such as immunodiffusion and immunoelectrophoresis, provide specific confirmation after a positive ELISA serology, and they were not used in this patient. [34] [6] Tunisia 1 19 Male Cauda equina MRI Albendazol + surgery Najib et al, 2012 [7] Morocco 3 42 Male Low back and leg pain CT Albendazol + surgery 37 Male MRI 25 Female Hemama et al 2011 [8] Morocco 1 9 Male Paraparesis MR (meningocele informed)…”