Primary Pelvic Hydatid Cyst

Abstract

Primary pelvic hydatid cyst rarely causes pressure on the lumbosacral plexus. This was a case of hydatid cyst in the pelvis causing sciatica and foot drop, and it indicates the pelvis as a hidden source of sciatica and foot drop. After surgical excision followed by 4 months' mebendazole therapy, there was no evidence of recurrence on long-term follow-up.

Imaging Findings of an Unusually Located Hydatid Cyst Presented as a Sacrococcygeal Mass

“…Our case was an example of a very unusual location of HD as a sacrococcygeal cystic mass. Lumbar disc herniation is the most common reason for sciatica, lower back pain and neurological symptoms ( 9 ). If there is no disc pathology, the vertebral column and pelvis should be examined to define the reason.…”

Pelvic hydatid disease: CT and MRI findings causing sciatica

“…Hydatid cysts are seldom primary in other organs, and they are often part of generalized disease. Involvement of the pelvis in hydatid disease is reported to be ≤2% (2-5). In female, genital organs are reported to be the most affected areas in pelvis which can be attributed to their relatively ample bloodstream and true invasions from connective tissue of peritoneum of Douglas and suspensory ligaments (2, 6) Pelvic hydatid disease can be presented with vague abdominal pains due to irritation, swelling, menstrual irregularities, infertility and pressure symptoms involving the adjacent organs (bladder, ureters, rectum and vascular structures) (2, 4, 7-9).…”

“…Symptoms indicative of compression of the lumbosacral plexus, as in our case, are really quite infrequent, and on very few occasions they have been reported (4-6). In the case of Martin-Serradilla et al (4), a pelvic hydatid cyst compressing the lumbosacral nerve plexus and the gluteal veins was shown by CT. Hassan et al (5) documented a pelvic hydatid cyst causing erosion in the roof of the sacral foramina, extending down to the coccygeal spine and causing swelling in the gluteal region, by CT.…”

“…Lumbar disc herniation affecting the lower lumbar root nerves is usually the reason of sciatica (5). Adnexial masses like endometrioma, acetabular labral cysts, iliopsoas bursal cysts and pelvic hydatid cysts, as in our case, are other rare pathologies that may compress the lumbosacral plexus and cause sciatica (10-12).…”