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

Correspondence Address:
Dr. Pragya Chaturvedi
Senior Resident, Department of Radio Diagnosis, SGPGIMS, Lucknow - 226014
India

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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}{Figure 2}

Spinal hydatid cysts account for 1% of all cases.[1] It is a severe disease with significant morbidity.[2] 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.[3]

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Conflicts of Interest

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