Presentation
Paraplegia. Had surgery twice for spinal cystic masses
Patient Data
There are multiple epidural intracanalar, and paravertebral (mainly on the left) cysts of various sizes, extending from C2-C3 to T10 -T11 level (length = 30 cm), composed of numerous daughter cysts of low signal intensity on T1WI, high signal intensity on T2WI with a peripheral hypointense rim of the pericyst. The solid matrix is of intermediate signal on both T1WI/T2WI with no enhancement on postcontrast sequences. The largest cyst is of left paravertebral location (9 x 8 x 7 cm), invading the adjacent T4, and T7 vertebra with T3-T4 dislocation. Involvement of the paraspinal soft tissue is also noted at T3-T4 and T10-T11 levels.
The spinal cord is compressed and displaced anteriorly.
No pulmonary, hepatic or splenic hydatid disease is noted.
The small size of the left kidney with bilateral hydronephrosis (known case of chronic nephropathy with bilateral urolithiasis).
Case Discussion
MRI features of spinal hydatid disease, type 3, 4, and 5 according to the Dew/Braithwaite and Lees classification.
Additional contributor: R. Bouguelaa, MD / A.Ramdani, MD