A Human Case of Lumbosacral Canal Sparganosis in China

Abstract

In this study, we intended to describe a human case of lumbosacral canal sparganosis in People's Republic of China (China). A 56-year-old man was admitted to Xiangya Hospital Central South University in Changsha, Hunan province, China after having an experience of perianal pain for a week. An enhancing mass, a tumor clinically suggested, was showed at the S1-S2 level of the lumbosacral spine by the examination of magnetic resonance imaging (MRI) with gadolinium contrast. The patient was received the laminectomy from S1 to S2, and an ivory-white living worm was detected in inferior margin of L5. In ELISA-test with cerebrospinal fluid (CSF) and serum samples, anti-sparganum antibodies were detected. He had a ingesting history of undercooked frog meat in his youth. By the present study, a human case of spinal sparganosis invaded in lumbosacral canal at the S1-S2 level was diagnosed in China. Although the surgical removal of larvae is known to be the best way of treatment for sparganosis, we administered the high-dosage of praziquantel, albendazole and dexamethasone to prevent the occurrence of another remain worms in this study.

Keywords: Sparganosis; lumbosacral spine; praziquantel; sparganum.

Fig. 1

Magnetic resonance imaging lumbosacral spines, sagittal plane. T1WI (A), gadolinium-enhanced T1WI (B), and T2WI (C) showed a 1.7×1.5×5.4 cm lesion (arrow) at the S1–S2 level. The lesion exhibited mixed isosignal intensity at T1WI, iso/hypersignal intensity at T2WI and heterogeneous and irregular enhancement at T1WI with GD. And there are cystic changes within the lesion.

Fig. 2

Operative field pictures. (A) After incision of the dura, the live worm (black arrow) was located at inferior margin of L5. (B) After removal of the worm, obvious proliferation of subdural granulation tissue was observed (yellow arrow).