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Case Reports
. 2016 Dec;7(Suppl 1):S112-S116.
doi: 10.4103/0976-3147.196456.

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

Manuel Segura-Trepichio  1 , Jose Manuel Montoza-Nuñez  1 , David Candela-Zaplana  1 , Josefa Herrero-Santacruz  2 , Fernando Pla-Mingorance  3
Affiliations
Case Reports

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

Manuel Segura-Trepichio et al. J Neurosci Rural Pract. 2016 Dec.

Abstract

Hydatid disease is caused by infection of Echinococcus granulosus. Bone hydatid cyst presentation without hepatic affectation is infrequent and occurs in 0,5-2% of cases. This rare condition makes clinicians not always aware of the disease, and as a result, misdiagnosis of spinal echinococcosis is common. We present a case of a 48-year-old female patient with primary sacral hydatidosis. Chronic low back pain radiating to the left buttock was the only symptom. The magnetic resonance imaging (MRI) suggested a neurogenic tumor versus giant cell tumor. Biopsy and pathological study revealed a hydatid cyst. Anthelmintic and surgical treatment was performed. At 12 months after surgery, the patient is free of recurrence. In patients with chronic low back pain and a MR suggestive of neurogenic tumor, spinal hydatid cyst should be considered in the differential diagnosis. It is recommended the assistance of an anesthesiologist during biopsy to avoid an anaphylactic shock.

Keywords: Echinococcosis; giant cell tumor of bone; hydatid disease; low back pain; spinal cord neoplasms.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Magnetic resonance T2-short-tau inversion recovery. Coronal, axial, and sagittal planes. Cystic lesion with cerebrospinal fluid-like signal in contact with left sacral roots extending through sacral holes reaching iliac muscle
Figure 2
Figure 2
Hydatid cyst (cyst wall, inner germinal layer) (H and E, ×200)
Figure 3
Figure 3
Ilium anterior approach, dissecting external oblique, internal oblique, and transversus abdominis after which the hydatid cyst was found
Figure 4
Figure 4
Posterior approach. (a) Hydatid cyst (highlighted in blue) on top of the dural sac. (b) First and second left sacral roots, after removing the hydatid cyst (highlighted in black)
Figure 5
Figure 5
Lumbopelvic instrumentation and bone grafting (femoral head) to fill the bone defect in the sacrum (highlighted with black arrows)
See this image and copyright information in PMC

References

    1. Papanikolaou A. Osseous hydatid disease. Trans R Soc Trop Med Hyg. 2008;102:233–8. - PubMed
    1. Echinococcosis Fact Sheet No. 377. World Health Organization; March. 2016. [Last retrieved on 2016 Mar 24]. http://www.who.int/mediacentre/factsheets/fs377/en/
    1. Khiari A, Fabre JM, Mzali R, Domergue J, Beyrouti MI. Unusual locations of hydatid cysts. Ann Gastroenterol Hepatol (Paris) 1995;31:295–305. - PubMed
    1. Agarwal S, Shah A, Kadhi SK, Rooney RJ. Hydatid bone disease of the pelvis. A report of two cases and review of the literature. Clin Orthop Relat Res. 1992;280:251–5. - PubMed
    1. Escarras A, Navatel P. Hydatid cyst of the sacrum. Mars Chir. 1951;3:493–4. - PubMed

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