Primary sacral hydatid cyst mimicking a neurogenic tumor in chronic low back pain: Case report and review of the literature

Manuel Segura-Trepichio, Jose Manuel Montoza-Nuñez, David Candela-Zaplana, Josefa Herrero-Santacruz, Fernando Pla-Mingorance

Journal of Neurosciences in Rural Practice 2016 7(5):112-116

Hydatid disease is caused by infection of Echinococcus granulosus. Bone hydatid cyst presentation without hepatic affectation is infrequent and occurs in 0,5-2% of cases. This rare condition makes clinicians not always aware of the disease, and as a result, misdiagnosis of spinal echinococcosis is common. We present a case of a 48-year-old female patient with primary sacral hydatidosis. Chronic low back pain radiating to the left buttock was the only symptom. The magnetic resonance imaging (MRI) suggested a neurogenic tumor versus giant cell tumor. Biopsy and pathological study revealed a hydatid cyst. Anthelmintic and surgical treatment was performed. At 12 months after surgery, the patient is free of recurrence. In patients with chronic low back pain and a MR suggestive of neurogenic tumor, spinal hydatid cyst should be considered in the differential diagnosis. It is recommended the assistance of an anesthesiologist during biopsy to avoid an anaphylactic shock.

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