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, Haopeng; Li, Kai; Deng, Qiang; Sheng, Weibin; Maimaiti, Maierdan; Guo, Hailong; Li, Huaqiang

doi:10.1016/j.ijid.2021.11.014

Cited by 6 publications

(3 citation statements)

References 39 publications

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“…In most cases, there is a lack of a connective tissue barrier against intraosseous hydatid cyst proliferation, allowing daughter cysts to enter the bone directly and grow in the bone marrow cavity along the direction of the epiphyseal plate and articular cartilage. 9 , 11 , 14 On imaging, the lesion will appear expansively honeycombed or soap bubble–shaped, with smooth and sclerotic margins. This growth pattern of hydatid bone disease determines its cystic and multilocular features.…”

Section: Discussionmentioning

confidence: 99%

Palliative Treatment for the Management of Advanced Pelvic Hydatid Bone Disease

Luan,

Liu,

Tian

et al. 2023

The American Journal of Tropical Medicine and Hygiene

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Hydatid bone disease is a zoonotic parasitic infection that is caused primarily by the tapeworm Echinococcus granulosus, and it continues to be a major public health concern in pastoral regions. The reconstruction of limb function after limb salvage surgery remains a challenge for clinicians. The purpose of this study was to determine the clinical efficacy of palliative treatment of the management of advanced pelvic hydatid bone disease. From March 2005 to December 2018, medical records and images of patients with advanced pelvic hydatid bone disease treated with surgery combined with antiparasitic chemotherapy were evaluated retrospectively. The Enneking classification was applied to determine the location of the lesion, and the Musculoskeletal Tumor Society score system was used for outcome evaluation. Fifteen patients who met the criteria were included in this study, with a mean follow-up of 4.40 ± 1.76 years. All patients received treatment with surgery combined with antiparasitic chemotherapy. The mean number of surgical interventions per patient for pelvic cystic echinococcosis was 5.3 (range, 2–9 interventions per patient). Recurrence of pelvic hydatid bone disease occurred in 5 patients and was managed successfully through repeated debridement procedures. Palliative treatment with limb salvage surgery was an effective and practical approach to the management of advanced pelvic hydatid bone disease. Standard antiparasitic chemotherapy, which included albendazole at a dose of 10 mg/kg/day administered in two daily doses for 3 to 6 months, was also considered an essential part of the overall treatment strategy.

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Section: Discussionmentioning

confidence: 99%

Palliative Treatment for the Management of Advanced Pelvic Hydatid Bone Disease

Luan,

Liu,

Tian

et al. 2023

The American Journal of Tropical Medicine and Hygiene

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“…Surgical recommendations for bone CE are as follows. (1) The bones and surrounding soft tissues infected by CE must be exposed ( Luan et al, 2022 ). (2) Integrity of the cyst wall must be ensured during resection of CE cysts ( Das et al, 2021 ).…”

Section: Treatment: Radical Resection and Drug Therapymentioning

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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“…Imaging examinations are of great importance in the diagnosis of echinococcoses. Computed tomography (CT) and magnetic resonance (MR) scans are highly beneficial in diagnosing echinococcosis as these examinations clearly show the location, size, extent, and degree of the lesion(s) [ 5 ]. However, the imaging manifestation of AE has a certain degree of similarity with the spinal tuberculosis and bone tumors, and it is frequently misdiagnosed.…”

Section: Introductionmentioning

confidence: 99%

Imaging Manifestations and Misdiagnosis Analysis of Six Cases of Bone Hydatid Disease

et al. 2022

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We retrospectively evaluated the clinical and imaging features of 6 patients with bone hydatid disease confirmed by surgery and pathological examination. Among the 6 patients, 2 were infected with Echinococcosis granulosus metacestode and 4 were infected with E. multilocularis metacestode. The 2 cases with cystic echinococcosis were diagnosed by computed tomographic (CT) examination, and other 4 cases were diagnosed by magnetic resonance (MR) imaging. On the initial evaluation, 1 case each was misdiagnosed as a giant cell tumor or neurogenic tumor, and 2 were misdiagnosed as tuberculosis. The imaging manifestations of bone hydatid disease are complex, but most common findings include expansive osteolytic bone destruction, which may be associated with sclerosing edges or dead bone formation, localized soft tissue masses, and vertebral lesions with wedge-shaped changes and spinal stenosis. Combining imaging findings with the patient’s epidemiological history and immunological examinations is of great help in improving the diagnosis and differential diagnosis of bone hydatid disease.

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

Cited by 6 publications

References 39 publications

Palliative Treatment for the Management of Advanced Pelvic Hydatid Bone Disease

Palliative Treatment for the Management of Advanced Pelvic Hydatid Bone Disease

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

Imaging Manifestations and Misdiagnosis Analysis of Six Cases of Bone Hydatid Disease

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