A 23-year-old female presented with spinal cord compression and worsening motor weakness due to an extradural cyst in the thoracic spine on MRI thought to be due to a benign, non-infective spinal arachnoid cyst. Surgical excision surprisingly revealed a histological diagnosis of a spinal hydatid cyst. This case highlights that hydatid cyst disease, though a rare spinal pathology, should be considered as a differential diagnosis using serology and history of transmission risk as part of the preoperative workup. This would allow the implementation of intraoperative precautions to minimise risk of recurrence. Despite no preoperative diagnosis in this case, surgical excision and adjunctive pharmacotherapy led to marked short term neurological improvement. Long-term follow-up with clinical assessment, imaging, serological testing, is vital to detect recurrence early and optimise long-term outcomes. If serological testing is positive preoperatively it will assist with follow-up screening for recurrence.
Deveduthras et al. (2025) studied this question.