Laparoscopic transdiaphragmatic approach to a thoracic paravertebral hydatid cyst presenting with compression myelopathy

Abstract

An elderly gentleman presented with heaviness over the right side of the chest, lower back pain and difficulty in walking for the last 6 months. He also reported of progressive weakness of the left leg associated with tingling and numbness for 2 months. Imaging studies revealed a large hydatid cyst in the right thoracic cavity compressing the spinal cord. The patient was prescribed a 14-day course of albendazole therapy. He underwent laparoscopic transdiaphragmatic deroofing and evacuation of the cyst. Postoperative recovery was uneventful. The patient started showing symptom relief from day 1 of surgery and by day 3, his right leg strength and sensation recovered remarkably. Echinococcal cyst is a zoonotic disease that can affect any part of the body. Vertebral involvement and spinal cord compression is a rare manifestation of echinococcal disease. Such cases pose diagnostic and therapeutic challenges and require a multidisciplinary approach to treat them successfully.