Dagtekin Ahmet, Koseoglu Aslihan, Kara Engin, Karabag Hamza, Avci Emel, Torun Fuat, Bagdatoglu Celal
Department of Neurosurgery, Medical Faculty, Mersin University, TR-33079 Mersin, Turkey.
Pediatr Neurosurg. 2009;45(5):379-83. doi: 10.1159/000260908. Epub 2009 Nov 26.
OBJECTIVE/AIMS: To emphasize the importance of diagnosis and treatment of unusually localized hydatid cysts in pediatric cases.
Hydatid cyst patients of two departments were listed who had undergone surgery between January 2001 and December 2008. Of the 7 pediatric patients, 3 were chosen as the ones with unusual localization. Cyst removal with Dowling's technique was performed in 2 cases and total removal of the cyst wall was achieved after cyst aspiration in the other patient.
Two patients did not show any signs of recurrence. Some of the cranial multiple cysts of the patient who had undergone her first surgery in another clinic with cyst rupture were successfully removed in our clinic. Six months later, she was admitted with spinal seedings.
Hydatid cyst removal without rupture should be the surgical goal in all cases. Radiological evaluation is of utmost importance for differential diagnosis. When a cystic lesion is found in the central nervous system on radiological evaluation, hydatid disease must be considered in countries where the disease is endemic and surgery is to be planned emergently especially for pediatric cases with increased intracranial pressure. The study focuses on the strategy for the correct diagnosis and the appropriate treatment of unusually localized hydatid cysts.
目的/目标:强调小儿病例中异常局限性包虫囊肿诊断和治疗的重要性。
列出2001年1月至2008年12月间两个科室接受手术的包虫囊肿患者。7名小儿患者中,3名被选为具有异常定位的患者。2例采用道林技术切除囊肿,另1例患者在囊肿抽吸后实现了囊肿壁的完全切除。
2例患者未出现任何复发迹象。在另一家诊所首次接受囊肿破裂手术的患者,其部分颅骨多发性囊肿在我们诊所成功切除。6个月后,她因脊髓播散入院。
所有病例的手术目标均应为无破裂地切除包虫囊肿。放射学评估对鉴别诊断至关重要。在该病流行的国家,当放射学评估在中枢神经系统发现囊性病变时,必须考虑包虫病,对于颅内压升高的小儿病例尤其要紧急规划手术。本研究聚焦于正确诊断和适当治疗异常局限性包虫囊肿的策略。