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儿童孤立性原发性硬脊膜外包虫囊肿导致进行性截瘫。

Isolated primary spinal epidural hydatid cyst in a child with progressive paraparesis.

机构信息

Department of Pediatric Neurosurgery, Children's Medical Center, Tehran University of Medical Sciences, Tehran, 1419733151, Iran.

Department of Pathology, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Childs Nerv Syst. 2021 Oct;37(10):3261-3264. doi: 10.1007/s00381-021-05100-3. Epub 2021 Mar 8.

Abstract

BACKGROUND

Primary spinal hydatid cyst is a rare but serious condition which occurs in about 1% of patients with hydatid disease. This disease may result in severe spinal cord compression presenting with various neurological deficits.

CASE REPORT

A 3-year-old boy was referred to our center with progressive weakness of lower limbs, frequency, and urinary incontinence. His parents did not report back pain during child's illness. Lumbar magnetic resonance imaging (MRI) revealed an extradural well-defined thin-walled cystic lesion at L4 to S3 vertebral levels without enhancement. The cyst had compressed the thecal sac associated with bone scalloping of vertebral bodies and posterior elements. Osteoplastic laminectomy of L4-L5 and laminectomy of S1-S3 was done. Intraoperative and histopathological findings indicated an epidural hydatid cyst.

CONCLUSION

Although spinal hydatid cysts are rare but might be considered in the differential diagnosis of any patient with signs and symptoms of spinal cord compression. The pathophysiology, clinical manifestations, epidemiology, diagnosis, and surgical treatment of extradural hydatid cyst are discussed.

摘要

背景

原发性脊柱包虫囊肿是一种罕见但严重的疾病,约占包虫病患者的 1%。这种疾病可能导致严重的脊髓压迫,表现出各种神经功能缺损。

病例报告

一名 3 岁男孩因进行性下肢无力、尿频和尿失禁而被转诊至我们中心。患儿在患病期间其父母未报告腰痛。腰椎磁共振成像(MRI)显示 L4 至 S3 椎体水平的硬膜外有一个界限清楚的薄壁囊性病变,无强化。囊肿压迫了硬脊膜囊,伴有椎体和后弓骨嵴。行 L4-L5 椎板成形术和 S1-S3 椎板切除术。术中及组织病理学检查提示硬膜外包虫囊肿。

结论

尽管脊柱包虫囊肿罕见,但对于任何有脊髓压迫体征和症状的患者,都应考虑将其作为鉴别诊断。讨论了硬膜外包虫囊肿的病理生理学、临床表现、流行病学、诊断和手术治疗。

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