Dogan Ihsan, Kahilogullari Gokmen, Guner Efe, Unlu Agahan
Department of Neurosurgery, School of Medicine, Ankara University, Sihhiye, 06100, Ankara, Turkey.
Childs Nerv Syst. 2015 Aug;31(8):1407-11. doi: 10.1007/s00381-015-2728-0. Epub 2015 May 1.
Involvement of spine in patients with hydatid disease (HD) is less than 1% and primary intra-spinal extradural HD is extremely rare. Although this disease is introduced as benign pathology according to its clinical presentation and biological behavior, intraoperative rupture of the cyst may aggravate the patients' outcome in the long-term especially in pediatric patient population.
We report a 9-year-old girl who presented a progressive neurological deterioration due to an enlargement of a ventrally located extradural hydatid cyst within the thoracic spinal canal. Total removal of the cyst was achieved by preserving the capsule integrity for preventing potential seeding. Our preoperative initial diagnosis based on the radiological findings was confirmed as cyst hydatid histopathologically.
Cyst hydatid should be considered in the differential diagnosis of the presence of homogenous cystic lesions with regular shape inside the spinal canal especially in patients from endemic region. To our knowledge, this pediatric patient is the first case of cyst hydatid located ventral side of the spinal cord extradurally located inside the spinal canal showing no extension.
棘球蚴病（HD）患者脊柱受累情况少于1%，原发性椎管内硬膜外HD极为罕见。尽管根据其临床表现和生物学行为该疾病被认为是良性病变，但术中囊肿破裂可能会在长期内加重患者的病情，尤其是在儿童患者群体中。
我们报告一名9岁女孩，因胸段椎管内腹侧硬膜外棘球蚴囊肿增大出现进行性神经功能恶化。通过保留囊肿包膜完整性以防止潜在播散，实现了囊肿的完全切除。我们术前基于影像学检查结果的初步诊断经组织病理学证实为棘球蚴囊肿。
对于椎管内存在形状规则的均匀囊性病变的患者，尤其是来自流行地区的患者，鉴别诊断时应考虑棘球蚴囊肿。据我们所知，该小儿患者是首例脊髓腹侧硬膜外位于椎管内且无延伸的棘球蚴囊肿病例。
