Imaging diagnosis and management of primary spinal hydatid disease: a case series

Abstract

Abstract Background Primary spinal hydatid disease (HD) is uncommon disease with significant morbidity. The diagnosis of this entity is not simple, unless the patient comes from an endemic area or has a history of HD elsewhere. Only few case reports and case series of this entity are available in the published literature. We report a series of three cases of primary spinal HD who had characteristic MR appearance and were managed successfully. Case presentation We report a series of 3 cases, two presenting with paraparesis and one with right lower limb weakness and hesitancy of micturition. MRI demonstrated multiloculated cystic lesion involving thoracic spine in two patients and lumbar spine in third patient. All the three patients were showing intraspinal extension with compression of neural structures. MRI features were characteristic of hydatid disease. All the three patients were managed surgically with gross total excision of the cysts followed by albendazole chemotherapy. Histopathology was consistent with hydatid cyst. Patients with dorsal spine disease showed improvement in motor weakness, but third one with lumbar spinal disease had to use foot splint for walking. None of the patient showed features of recurrence on follow-up. Conclusion Radiologist should be familiar with the typical and atypical manifestations of the disease and should keep it in the differential diagnosis of cystic spinal lesions. Radical surgical excision along with postoperative adjuvant albendazole chemotherapy is the mainstay of treatment.