Incurable and refractory spinal cystic echinococcosis: A case report  

作　　者：Tao Zhang Li-Hua Ma Hua Liu Song-Kai Li 

机构地区：[1]Department of Spine Surgery,the 940th Hospital of Joint Logistics Support Force of Chinese PLA,Lanzhou 730050,Gansu Province,China [2]the First Hospital of Lanzhou University,Lanzhou 730050,Gansu Province,China

出　　处：《World Journal of Clinical Cases》2021年第33期10337-10344,共8页世界临床病例杂志

基　　金：Supported by Chinese People's Liberation Army Medical Technology Youth Training Program,No.20QNPY071;and the Natural Science Foundation of Gansu Province,No.21YF1FA179,No.GSWSKY2020-05 and No.21JR1RA106.

摘　　要：BACKGROUND Although the incidence and cure rate of spinal hydatidosis are low,the recurrence rate of spinal hydatidosis is high,and the prognosis of spinal hydatidosis is poor.Therefore,we report a typical case of refractory spinal hydatidosis to increase spine surgeons’awareness of the disease and reduce misdiagnosis and recurrence.CASE SUMMARY A 48-year-old man presented with back pain,significant weight loss,and paralysis of both lower limbs.The patient was misdiagnosed with spinal tuberculosis in an outside hospital.However,spinal magnetic resonance imaging(MRI)showed hyperintense cystic components on T2-weighted images and hypointensity on T1-weighted images.A lobulated,multiocular,honeycombappearance,septated cystic mass protruding intraspinally and compressing the spinal cord at segments T8–T9 was present.Paravertebral polycystic lobular lesions presented as a“bunch of grapes”.The ELISA test result for Echinococcus granulosus was positive.Then,a diagnosis of spinal hydatidosis and lung hydatid disease was made,and the patient underwent left transthoracic approach lobectomy,paravertebral lesion debridement,and subtotal vertebrectomy with vertebral body replacement of segments T8 and T9 by a mesh cage.The patient also underwent albendazole chemotherapy before and after surgery.One year after stopping the drug therapy,the patient developed recurrent T5 vertebral lesions and underwent a second subtotal vertebrectomy surgery.The patient is currently in good condition and is receiving long-term medication and follow-up.CONCLUSION The MRI feature of a“bunch of grapes”is a typical imaging indication of spinal hydatidosis.Subtotal vertebrectomy is a risk factor for postoperative recurrence.Total spondylectomy makes it possible to cure spinal hydatidosis,but antiparasitic drug therapy is also an important supplementary therapy to multimodal therapy.It is preferable for patients with spinal hydatidosis to receive life-long antiparasitic medication therapy and follow-up.

关 键 词：Cystic echinococcosis Spinal hydatidosis RECURRENCE Case report 

分 类 号：R532.32[医药卫生—内科学]