A sacral hydatid cyst mimicking an anterior sacral meningocele

Case report

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Hydatid disease is a zoonosis caused by Echinococcus granulosus. It is a progressive disease with serious morbidity risks. Sacral hydatid disease is very uncommon, accounting for < 11% of spinal hydatidosis cases. The diagnosis of a sacral hydatid cyst is sometimes difficult because hydatidosis can simulate other cystic pathologies. The authors report on 9-year-old boy admitted to their service with a paraparesis that allowed walking without aid. The boy presented with a 2-year history of an evolving incomplete cauda equina syndrome as well as a soft cystic mass in the abdomen extending from the pelvis. Radiological examination revealed an anterior meningocele. A posterior approach with laminectomy from L-5 to S-3 was performed. Three lesions with classic features of a hydatid cyst were observed and removed. The diagnosis of hydatid cyst was confirmed histopathologically. Antihelmintic treatment with albendazole (15 mg/kg/day) was included in the postoperative treatment. The patient's condition improved after surgery, and he recovered normal mobility.

The unusual site and presentation of hydatid disease in this patient clearly supports the consideration of spinal hydatid disease in the differential diagnosis for any mass in the body, especially in endemic areas.

Article Information

Address correspondence to: Mustapha Hemama, M.D., Hôpital des Spécialités O.N.O., Rabat, Morocco. email: mhemama@yahoo.com.

© AANS, except where prohibited by US copyright law.



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    Axial (left) and sagittal (right) T1-weighted MR images showing a dumbbell-shaped hypointense pelvic lesion communicating with an intraspinal component through the left lateral sacral mass.

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    Photograph of a white glistening mass on laminectomy.

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    Photograph of the capsules after removal of the cysts.

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    Three-dimensional CT scan outlining the sacral defect.


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