Hemama Mustapha, Lasseini Ali, Rifi Loubna, Boutarbouch Mahjouba, Derraz Said, Ouahabi Abdessamad El, Khamlichi Abdeslam El
Service de Neurochirurgie, Hôpital des Spécialités O.N.O., Rabat, Morocco.
J Neurosurg Pediatr. 2011 Nov;8(5):526-9. doi: 10.3171/2011.8.PEDS10555.
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.
包虫病是一种由细粒棘球绦虫引起的人畜共患病。它是一种具有严重发病风险的进行性疾病。骶骨包虫病非常罕见,占脊柱包虫病病例的不到11%。骶骨包虫囊肿的诊断有时很困难,因为包虫病可能会模拟其他囊性病变。作者报告了一名9岁男孩因双下肢轻瘫入院,该患儿无需辅助即可行走。该男孩有2年逐渐发展的不完全马尾综合征病史,以及从骨盆延伸至腹部的柔软囊性肿块。影像学检查显示为前侧脑脊膜膨出。实施了从L5至S3的后路椎板切除术。观察到并切除了3个具有包虫囊肿典型特征的病灶。包虫囊肿的诊断经组织病理学证实。术后治疗包括使用阿苯达唑(15毫克/千克/天)进行抗蠕虫治疗。患者术后病情改善,恢复了正常活动能力。该患者包虫病不寻常的部位和表现明确支持在对身体任何肿块进行鉴别诊断时考虑脊柱包虫病,尤其是在流行地区。