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Table of Contents    
NEUROIMAGE
Year : 2021  |  Volume : 69  |  Issue : 6  |  Page : 1631-1632

Primary Multilocular Extradural Spinal Hydatid Cyst


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 Submission21-Jan-2021
Date of Decision29-Mar-2021
Date of Acceptance05-May-2021
Date of Web Publication23-Dec-2021

Correspondence Address:
Dr. Pragya Chaturvedi
Senior Resident, Department of Radio Diagnosis, SGPGIMS, Lucknow - 226014
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0028-3886.333517

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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

How to cite this URL:
Chaturvedi P, Sharma S, Dwivedi A, Kumar K. Primary Multilocular Extradural Spinal Hydatid Cyst. Neurol India [serial online] 2021 [cited 2022 Jan 26];69:1631-2. Available from: https://www.neurologyindia.com/text.asp?2021/69/6/1631/333517




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.[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

There are no conflicts of interest.



 
  References Top

1.
Kahilogullari G, Tuna H, Aydin Z, Colpan E, Egemen N. Primary intradural extramedullary hydatid cyst. Am J Med Sci 2005;329:202-4.  Back to cited text no. 1
    
2.
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.  Back to cited text no. 2
    
3.
Lam KS, Faraj A, Mulholland RC, Finch RG. Medical decompression of vertebral hydatidosis. Spine (Phila Pa 1976) 1997;22:2050-5.  Back to cited text no. 3
    


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