[Sciatica in a Tunisian teenager: pelvic hydatid cyst]. / Lombosciatique chez un adolescent tunisien. Kyste hydatique pelvien.

The purpose of this report is to describe the case of a 13-year-old boy presenting typical sciatica leading to the discovery of primary pelvic hydatid cyst extending to the ischiatic bone. Diagnosis was suspected based on echography and magnetic resonance imaging and confirmed by surgical exploration.

Sciatica of nondisc origin: hydatid cyst of the sciatic nerve. Case report.

The authors report on an 81-year-old woman with a primary hydatid cyst located in the posteromedial aspect of the thigh. She presented with sciatica, and the cyst was also associated with neurological dysfunction because of its intra-neural location. Diagnosis of a cyst in a nerve body is very rare, and the one reported here might be the first such case. So far, in all the previously reported cases in which there were also neurological findings, the cysts in the vertebral column were compressing the spinal cord or there was an intrapelvic mass compressing the sciatic nerve. Hydatid cyst should be considered in the differential diagnosis of sciatica, especially when treating patients who live in or have emigrated from areas of the world where Echinococcus granulosus is prevalent.

Pelvic hydatid disease: CT and MRI findings causing sciatica.

Pelvic masses, especially hydatid disease, rarely present with sciatica (1, 2). We present the computed tomography (CT) and the magnetic resonance imaging (MRI) findings of a 49-year-old female patient with presacral hydatid disease, who was evaluated for her sciatica. We also want to emphasize the importance of assessing the pelvis of patients with symptoms and clinical findings that are inconsistent and that cannot be satisfactorily explained by the spinal imaging findings.

Cauda equina syndrome caused by primary lumbosacral and pelvic hydatid cyst: a case report.

INTRODUCTION: Hydatid disease occurs in humans as a result of faeco-oral contamination and spinal echinococcosis is rare even in areas where echinococcosis is endemic. Hydatid cyst primarily occurs in the liver and lungs. Bone involvement constitutes only 0.5-2% of all hydatidoses. About half of the bone involvement occurs in vertebrae. The thoracic spine is the most common site of the spinal hydatidosis. Primary hydatid cysts of the lumbar and sacral spinal canal are very rare. CASE REPORT: We present a 31-year-old man with cauda equina syndrome caused by a primary hydatid cyst of the lumbosacral and pelvic areas. He had been admitted to hospital with left foot and low back pain three years ago. Magnetic resonance imaging revealed an intraspinal hydatid cyst extending from L2 to S2. The cyst had been totally removed. He was symptom-free for three years. After three years, he presented with acute cauda equina syndrome. His neurological examination revealed total plegia of dorsal flexion of the left foot and perianal hypoaesthesia. MRI showed lumbosacral and pelvic hydatidosis again. After total removal of the cyst, his neurological status revealed immediately relief. DISCUSSION: Hydatid cyst is an important health problem in some countries including Turkey. Bone involvement is seen in only 0.5-2% of cases. Furthermore sacral and lumber vertebral involvement is extremely rare. We presented a case with a spinal hydatid cyst which classified as a combination of intraspinal extradural, vertebral and paravertebral forms according to the Braitwate and Lees classification. Surgical excision and additional medical treatment is still the most effective treatment. Cysts located intraspinally have a tendency to rupture spontaneously. For this reason the high recurrence rate (30- 40%) is still a major problem in management.

Primary pelvic hydatid cyst: an unusual cause of sciatica and foot drop.

STUDY DESIGN: A case report of primary pelvic hydatid cyst causing sciatica and foot drop. OBJECTIVE: To document the occurrence of primary pelvic hydatid cyst as one of the hidden causes of lower limb weakness and foot drop, and to recommend inclusion of the pelvic cavity when assessing sciatica and foot drop. SUMMARY OF BACKGROUND DATA: It is common to see foot drop caused by peripheral lesions around the knee or disc herniation in the lumbar spine, but if these sites were excluded, the pelvic cavity must be examined for hidden disease that may explain the cause of foot drop and sciatica. METHODS: The authors involved in the care and management of this patient were interviewed and all medical records, radiologic investigations, and related literature were reviewed. RESULTS: After exclusion of spinal and peripheral causes of foot drop, computed tomography of the pelvis showed a well-localized cystic swelling in the right side of the pelvis over the lumbosacral plexus roots. Surgical excision of the cyst resulted in partial recovery of the foot drop at 3 years of follow-up. CONCLUSION: Primary pelvic hydatid cyst rarely causes pressure on the lumbosacral plexus. This was a case of hydatid cyst in the pelvis causing sciatica and foot drop, and it indicates the pelvis as a hidden source of sciatica and foot drop. After surgical excision followed by 4 months' mebendazole therapy, there was no evidence of recurrence on long-term follow-up.