Epidural Spinal Cord Compression by an Abscess from a Dumbbell Extension of a Non-Osseous Soft Tissue Paravertebral Hydatid Cyst in the Dorsal Region

Abstract

Background and objectives: Human being may become infested with Echinococcus granulosus, as an intermediate host, ending with the formation of hydatid cyst. Hydatidosis, affecting various parts of human body and should be considered in the differential diagnosis of any cystic mass lesion. Osseous Hydatid cyst is rare; however, it involves the spinal column in half of the cases. In the current study, the epidural hydatid cyst had presented with spinal cord compression due to the formation of an epidural abscess formation.

Methods: A young adult housewife lady who had been affected by the parasite, primary paravertebral hydatid cyst, between the seventh and ninth dorsal vertebral levels, presented with spinal cord compression due to epidural abscess lesion. Ultrasound, the contrast magnetic resonance, and computed tomography imaging are standard tests in the diagnostic work-up of the lesion and follow-up of the patient. Appropriate dorsal laminectomy, removal of the hydatid cyst, and the inflammatory epidural cystic compressing tissues were done.

Results: Operative intervention had resulted in a dramatic improvement in the patient's condition and reversal of her neurological deficit back to normal; the paravertebral ectocyst size had eventually shrunken and there was no recurrence. The excised tissues that were compressing the dorsal spinal cord proved, Histopathologically, to be inflammatory in its microscopical appearance.

Conclusions: Hydatid cyst epidural dumbbell extension may rupture and lead to the formation of an abscess, giving enhancement on contrast magnetic resonance and computed tomography scan studies. To our knowledge, this is the first case to be reported in the literature specifying spinal cord compression by an epidural abscess formation from a paraspinal dumbbell extension of hydatid cyst.