Presentation
Lower back pain and lower limb weakness.
Patient Data
There is a multilocular intraspinal canal fluid-intensity cystic lesion at levels of S1, S2, and S3 vertebrae.
The lesion extends through the neural foramen of S1/S2 and S2/S3 levels on both sides, widening them.
The lesion has some components posterior to the left S1/S2 neural foramen that reach the left SIJ.
The lesion is hypo in T1 and hyper in T2, and there is no enhancement in the post-contrast study.
Case Discussion
Spinal hydatid disease is an uncommon manifestation of hydatid disease, caused by the larval stage of Echinococcus granulosus, or less commonly, E. alveolaris or E. multilocularis, and describes a spectrum of disease involving the spinal cord, the spine, or both.
Spinal hydatid disease can be anatomically classified according to Dew/Braithwaite and Lees classifications 1-3:
type 1: intramedullary
type 2: intradural, extramedullary
type 3: extradural, intraspinal
type 4: vertebral
type 5: paravertebral
Our case was intra-dural in location and had two hydatid cysts at the liver.
Acknowledgement: Dr. Ali Sharaf Aldine (a neurosurgeon specialist) contributed to the diagnosis of this patient.
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