Hydatid cyst of the thoracic spine – where can we make a mistake?

Abstract

Introduction Spinal hydatid cyst disease, caused by Echinococcus granulosus, is a rare yet challenging condition often overlooked in differential diagnoses.

Case outline We present the case of a 41-year-old woman with a spinal hydatid cyst initially misdiagnosed despite persistent thoracic spine pain, night fevers, and a history of chiropractic and physical therapy treatments. Diagnostic confusion persisted despite various examinations, including X-rays, computed tomography scans, and magnetic resonance imaging, with radiological findings initially suggestive of osteomyelitis or neoplastic changes. Ultimately, surgical intervention revealed a hydatid cyst, emphasizing the diagnostic challenges posed by its nonspecific radiographic features. Treatment involved a corpectomy with spinal stabilization and postoperative albendazole therapy. Regular radiographic monitoring showed no recurrence or dissemination of the cyst.

Conclusion Despite the rarity of spinal hydatid cysts, they should be considered in cases of cystic lesions causing spinal compression. Surgery remains the cornerstone of treatment, often combined with long-term chemotherapy. This case underscores the importance of considering uncommon diagnoses in persistent spinal pathology and highlights the complexities of diagnosing and managing spinal hydatid cyst disease.

Keywords: spinal hydatid cyst; Echinococcus granulosus; misdiagnosis; surgical treatment; chemotherapy