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|Year : 2021 | Volume
| Issue : 6 | Page : 1631-1632
Primary Multilocular Extradural Spinal Hydatid Cyst
Pragya Chaturvedi1, Srishti Sharma1, Ashish Dwivedi2, Kunjan Kumar3
1 Department of Radio Diagnosis, SGPGIMS, Lucknow, India
2 Department of Anesthesia, PGI, Chandigarh, India
3 Department of Urology, RG KAR, Kolkata, India
|Date of Submission||21-Jan-2021|
|Date of Decision||29-Mar-2021|
|Date of Acceptance||05-May-2021|
|Date of Web Publication||23-Dec-2021|
Dr. Pragya Chaturvedi
Senior Resident, Department of Radio Diagnosis, SGPGIMS, Lucknow - 226014
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Chaturvedi P, Sharma S, Dwivedi A, Kumar K. Primary Multilocular Extradural Spinal Hydatid Cyst. Neurol India 2021;69:1631-2
A 55-year-old male presented with back pain and gradually increasing weakness in lower limbs for 2 months and diminished sensations below umbilicus for 15 days. Motor examination revealed reduced power (2/5) with spasticity in lower limbs. Deep tendon reflexes were brisk and extensor plantar response was present. On the basis of clinical examination, extradural compressive dorsal myelopathy was suspected. Magnetic resonance imaging (MRI) revealed a multicystic T1 hypointense [Figure 1] and T2 hyperintense [Figure 2] extradural lesions at D10 with a bunch of daughter cysts. The lesion was extending into the posterior epidural and right paraspinal space with the involvement of D10 vertebral body. Compression over the adjacent spinal cord was seen without altered signal intensity. On imaging, differentials were hydatid cyst of spine and aneurysmal bone cyst. The patient was operated and pathological examination revealed echinococcosis. Ultrasonography (USG) and Computed tomography (CT) revealed no other hydatid cysts in the body.
|Figure 1: (a) and (b) Axial and sagittal T1 W. (c) MRI of thoracic spine shows multilobulated hypointense lesion of the tenth thoracic vertebra with epidural component|
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|Figure 2: (a and b) Sagittal and axial T2 W. (c and d) MRI shows multilobulated hyperintense lesion with bunch like daughter cysts in right and paravertebral space with involvement of D10 vertebral body. Cystic epidural component also seen causing compression of dorsal cord|
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Spinal hydatid cysts account for 1% of all cases. It is a severe disease with significant morbidity. The treatment of choice is surgical management using anterior or posterior approaches. Extensive bone resection with stabilization and grafting decreases recurrence and slows progression rate. Historically, simple decompression by laminectomy was the most commonly utilized procedure. Pharmacological intervention using albendazole slows progression and can be used in conjunction with surgery.
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Conflicts of Interest
There are no conflicts of interest.
| » References|| |
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Cavus G, Acik V, Bilgin E, Gezercan Y, Okten AI. Endless story of a spinal column hydatid cyst disease: A case report. Acta Orthop Traumatol Turc 2018;52:397-403.
Lam KS, Faraj A, Mulholland RC, Finch RG. Medical decompression of vertebral hydatidosis. Spine (Phila Pa 1976) 1997;22:2050-5.
[Figure 1], [Figure 2]