Bulut H Taner, Yildirim Adem, Celik Tuncay, Baykan Ali Haydar, Sürücü Gülseren Dost, Ekmekçi Burcu
Department of Radiology, Adiyaman University, Adiyaman, Turkey.
Spine (Phila Pa 1976). 2013 Aug 15;38(18):E1175-7. doi: 10.1097/BRS.0b013e31829a8357.
Case report.
To present a case of primary hydatid cyst in the lumbar subcutaneous tissue affecting posterior paravertebral muscle and mimicking disc herniation.
Cystic hydatid disease is a rare but significant parasitic disease in endemic areas. Musculoskeletal or soft tissue hydatidosis accounts for about 0.5% to 5% of all echinococcal infections in endemic areas and is almost secondary to the hepatic or pulmonary disease. Primary lumbar subcutaneous hydatid cyst affecting paravertebral muscle and extending to neural foramina is a very rare condition even in endemic areas.
A 25-year-old-female patient was admitted with swelling and pain in the right lumbar region for 3 months. The pain was reflecting in the right gluteal region and the right leg. Lumbar extension and right lateral flexion was painful and straight leg raising test was positive at right side. There was a mild hypoesthesia at L5 dermatome. According to the magnetic resonance image that the clinician obtained for initial diagnosis of lumbar disc herniation, we found multi-cystic masses located at the right paravertebral muscle at the level of L3-L5 which extended to L4-L5 neural foramina and at subcutaneous tissue at the right gluteal region.
The patient was operated for the purpose of removal of cysts. Postoperatively, diagnosis of hydatid cyst was confirmed by histopathology.
By this case, we emphasize that cystic hydatid disease should be taken into consideration in the differential diagnosis of low back pain and could mimic disc herniation.
N/A.
病例报告。
报告一例原发性腰椎皮下组织包虫囊肿病例，该囊肿累及椎旁肌后部并酷似椎间盘突出症。
囊性包虫病在流行地区是一种罕见但重要的寄生虫病。肌肉骨骼或软组织包虫病在流行地区占所有棘球蚴感染的0.5%至5%，几乎继发于肝脏或肺部疾病。即使在流行地区，原发性腰椎皮下包虫囊肿累及椎旁肌并延伸至神经孔也是一种非常罕见的情况。
一名25岁女性患者因右腰区肿胀疼痛3个月入院。疼痛放射至右臀区及右腿。腰椎后伸及右侧侧屈时疼痛，右侧直腿抬高试验阳性。L5皮节有轻度感觉减退。根据临床医生为初步诊断腰椎间盘突出症所获取的磁共振图像，我们发现多个囊性肿块位于L3-L5水平的右侧椎旁肌，并延伸至L4-L5神经孔以及右臀区的皮下组织。
患者接受了囊肿切除术。术后，组织病理学证实为包虫囊肿。
通过本病例，我们强调在腰痛的鉴别诊断中应考虑囊性包虫病，它可能酷似椎间盘突出症。
无。
