Spinal intradural hydatid cyst causing arachnoiditis: A rare etiology of cauda equina syndrome.

This research article discusses a rare case where a spinal hydatid cyst, a type of parasitic infection, mimicked a benign intradural extramedullary (IDEM) tumor, causing the patient to exhibit cauda equina syndrome. Through a study of this specific case, the research showcases that spinal hydatid cyst can occasionally cause the syndrome, and it could be misdiagnosed due to its similarity to benign tumoral lesions on MRI scans.

Introduction

Spinal hydatid cyst is a parasitic infection brought about by the Echinococcus genus of tapeworm. In this study, the focus is on a singular case where the cyst manifested itself in a way similar to an IDEM (tumor inside the spine, but outside the spinal cord). The condition presented as cauda equina syndrome, a critical condition where the bundle of nerve roots at the end of the spinal cord are damaged.

Case Presentation

• The patient in focus was an 11-year-old boy, who exhibited symptoms of cauda equina syndrome.
• The initial radiological examination indicated a presumed diagnosis of neurofibroma, which is a benign nerve sheath tumor.
• However, during surgical intervention, the presence of multiple cystic lesions and severe arachnoiditis (inflammation of the arachnoid, one of the thin layers surrounding the brain and spinal cord) hinted at a different diagnosis.

Surgery and Findings

• A dissection in the plane of the supposed cyst led to the flushing out of the cystic lesion.
• The surgical area was then treated with 3% saline to cleanse the region.

Diagnosis and Conclusion

• The definitive diagnosis was only confirmed postoperatively through histopathological findings and serum tests, which provided evidence of a hydatid cyst.
• The researchers concluded that hydatid cyst can also cause cauda equina syndrome, and its diagnosis may be complicated due to the similarity of the cyst to benign tumoral lesions in radiological examinations.
• The article suggests the need to maintain a high index of suspicion, especially for young patients from the Indian subcontinent, owing to the high incidence of the disease in this region.