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KEY FACTS
Terminology
Imaging
Pathology
Clinical Issues
Diagnostic Checklist
TERMINOLOGY
Synonyms
- Hydatidosis, hydatid disease, hydatid cyst disease
Definitions
- Disease caused by cyst stage of infestation by tapeworm Echinococcus species
- Liver, lung involvement most common
- Bone (0.5-4%) → spine involved in 50% of cases
- Multiple echinococcal species produce disease; complex life cycle
- Echinococcus granulosus: Causative agent of hydatid disease in man/other mammals
- Dog is definite host; parasitized by adult tapeworm
- Gravid proglottids shed by tapeworm, disintegrate in dog intestine
- Eggs passed in feces
- Mammals act as intermediate host after ingestion of eggs (typically sheep, cattle)
- Eggs hatch in intestine, penetrate gut wall, travel via lymphatic/blood vessels throughout body
- Cyst develops into infective protoscolices in 1-2 years
- Dogs then ingest protoscolices on death of intermediate host (predation/scavenging)
- Cyst wall digested in gut, allowing development of adult worms
- Dog is definite host; parasitized by adult tapeworm
- E. multilocularis: Causative agent of alveolar hydatid disease in man/other mammals
- Fox is most important definitive host
- Cyst grows invasively by external budding, diffuse growth through infected organ
- Presents as ramifying, porous, necrotic mass
- E. vogeli: Polycystic form in Central and South America
- Bush dog is definitive host
- Echinococcus granulosus: Causative agent of hydatid disease in man/other mammals
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Nonvascular Interventions
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
- Saul D et al: Of Cestodes and men: surgical treatment of a spinal hydatid cyst. J Neurol Surg A Cent Eur Neurosurg. 81(1):86-90, 2020
- Padayachy LC et al: Hydatid disease (Echinococcus) of the central nervous system. Childs Nerv Syst. 34(10):1967-71, 2018
- Agnihotri M et al: Hydatid disease of the spine: a rare case. J Craniovertebr Junction Spine. 8(2):159-60, 2017
- Neumayr A et al: Spinal cystic echinococcosis--a systematic analysis and review of the literature: part 1. Epidemiology and anatomy. PLoS Negl Trop Dis. 7(9):e2450, 2013
- Neumayr A et al: Spinal cystic echinococcosis--a systematic analysis and review of the literature: part 2. Treatment, follow-up and outcome. PLoS Negl Trop Dis. 7(9):e2458, 2013
- Thaler M et al: Severe kyphoscoliosis after primary Echinococcus granulosus infection of the spine. Eur Spine J. 19(9):1415-22, 2010
- Doganay S et al: Role of conventional and diffusion-weighted magnetic resonance imaging of spinal treatment protocol for hydatid disease. J Spinal Cord Med. 32(5):574-7, 2009
- Güneçs M et al: Multiple intradural spinal hydatid disease: a case report and review of literature. Spine (Phila Pa 1976). 34(9):E346-50, 2009
- Lakhdar F et al: Spinal intradural extramedullary hydatidosis: report of three cases. Neurosurgery. 65(2):372-6; discussion 376-7, 2009
- Sasani M et al: Spontaneous drainage of an asymptomatic recurrent hydatid cyst of the sacrum. Spine (Phila Pa 1976). 34(7):E269-71, 2009
- Viljoen H et al: Hydatid disease of the spine. Spine (Phila Pa 1976). 33(22):2479-80, 2008
- El-Arousy MH et al: Cerebrospinal echinococcosis: serodiagnosis using different hydatid cyst fluid antigens. J Egypt Soc Parasitol. 35(1):193-204, 2005
- El Kohen A et al: Multiple hydatid cysts of the neck, the nasopharynx and the skull base revealing cervical vertebral hydatid disease. Int J Pediatr Otorhinolaryngol. 67(6):655-62, 2003
- Hadjipavlou AG et al: Effectiveness and pitfalls of percutaneous transpedicle biopsy of the spine. Clin Orthop. (411):54-60, 2003
- Karadereler S et al: Primary spinal extradural hydatid cyst in a child: case report and review of the literature. Eur Spine J. 11(5):500-3, 2002
- Hassan FO et al: Primary pelvic hydatid cyst: an unusual cause of sciatica and foot drop. Spine. 26(2):230-2, 2001
- Sener RN et al: Multiple, primary spinal-paraspinal hydatid cysts. Eur Radiol. 11(11):2314-6, 2001
- Stabler A et al: Imaging of spinal infection. Radiol Clin North Am. 39(1):115-35, 2001
- Bruschi F et al: Immunochemical and molecular characterization of vertebral hydatid fluid. Scand J Infect Dis. 31(3):322-3, 1999
- Savas R et al: Spinal cord compression due to costal Echinococcus multilocularis. Comput Med Imaging Graph. 23(2):85-8, 1999
- Mazyad MA et al: Spinal cord hydatid cysts in Egypt. J Egypt Soc Parasitol. 28(3):655-8, 1998
- Normelli HC et al: Vertebral hydatid cyst infection (Echinococcus granulosus): a case report. Eur Spine J. 7(2):158-61, 1998
- von Sinner WN et al: Case report 833: Primary spinal echinococcosis (Echinococcus granulosus) of lumbosacral spine with destruction of the left pedicles of L3-5 and extension of a large paraspinal cystic mass into the spinal canal. Skeletal Radiol. 23(3):220-3, 1994
- Sharif HS: Role of MR imaging in the management of spinal infections. AJR Am J Roentgenol. 158(6):1333-45, 1992
- Dernevik L et al: Management of dumbbell tumours. Reports of seven cases. Scand J Thorac Cardiovasc Surg. 24(1):47-51, 1990
- Richards KS et al: Effect of albendazole on human hydatid cysts: an ultrastructural study. HPB Surg. 2(2):105-12; discussion 112-3, 1990
- Charles RW et al: Echinococcal infection of the spine with neural involvement. Spine. 13(1):47-9, 1988
- Bhargava S: Radiology--including computed tomography--of parasitic diseases of the central nervous system. Neurosurg Rev. 6(3):129-37, 1983
- Braithwaite PA et al: Vertebral hydatid disease: radiological assessment. Radiology. 140(3):763-6, 1981
- Kaufman DM et al: Infectious agents in spinal epidural abscesses. Neurology. 30(8):844-50, 1980
- Karvounis PC et al: Intradural spinal echinococcus simulating lumbar disc protrusion. Neurochirurgia (Stuttg). 20(2):58-60, 1977
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Pathology
Clinical Issues
Diagnostic Checklist
TERMINOLOGY
Synonyms
- Hydatidosis, hydatid disease, hydatid cyst disease
Definitions
- Disease caused by cyst stage of infestation by tapeworm Echinococcus species
- Liver, lung involvement most common
- Bone (0.5-4%) → spine involved in 50% of cases
- Multiple echinococcal species produce disease; complex life cycle
- Echinococcus granulosus: Causative agent of hydatid disease in man/other mammals
- Dog is definite host; parasitized by adult tapeworm
- Gravid proglottids shed by tapeworm, disintegrate in dog intestine
- Eggs passed in feces
- Mammals act as intermediate host after ingestion of eggs (typically sheep, cattle)
- Eggs hatch in intestine, penetrate gut wall, travel via lymphatic/blood vessels throughout body
- Cyst develops into infective protoscolices in 1-2 years
- Dogs then ingest protoscolices on death of intermediate host (predation/scavenging)
- Cyst wall digested in gut, allowing development of adult worms
- Dog is definite host; parasitized by adult tapeworm
- E. multilocularis: Causative agent of alveolar hydatid disease in man/other mammals
- Fox is most important definitive host
- Cyst grows invasively by external budding, diffuse growth through infected organ
- Presents as ramifying, porous, necrotic mass
- E. vogeli: Polycystic form in Central and South America
- Bush dog is definitive host
- Echinococcus granulosus: Causative agent of hydatid disease in man/other mammals
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Nonvascular Interventions
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
- Saul D et al: Of Cestodes and men: surgical treatment of a spinal hydatid cyst. J Neurol Surg A Cent Eur Neurosurg. 81(1):86-90, 2020
- Padayachy LC et al: Hydatid disease (Echinococcus) of the central nervous system. Childs Nerv Syst. 34(10):1967-71, 2018
- Agnihotri M et al: Hydatid disease of the spine: a rare case. J Craniovertebr Junction Spine. 8(2):159-60, 2017
- Neumayr A et al: Spinal cystic echinococcosis--a systematic analysis and review of the literature: part 1. Epidemiology and anatomy. PLoS Negl Trop Dis. 7(9):e2450, 2013
- Neumayr A et al: Spinal cystic echinococcosis--a systematic analysis and review of the literature: part 2. Treatment, follow-up and outcome. PLoS Negl Trop Dis. 7(9):e2458, 2013
- Thaler M et al: Severe kyphoscoliosis after primary Echinococcus granulosus infection of the spine. Eur Spine J. 19(9):1415-22, 2010
- Doganay S et al: Role of conventional and diffusion-weighted magnetic resonance imaging of spinal treatment protocol for hydatid disease. J Spinal Cord Med. 32(5):574-7, 2009
- Güneçs M et al: Multiple intradural spinal hydatid disease: a case report and review of literature. Spine (Phila Pa 1976). 34(9):E346-50, 2009
- Lakhdar F et al: Spinal intradural extramedullary hydatidosis: report of three cases. Neurosurgery. 65(2):372-6; discussion 376-7, 2009
- Sasani M et al: Spontaneous drainage of an asymptomatic recurrent hydatid cyst of the sacrum. Spine (Phila Pa 1976). 34(7):E269-71, 2009
- Viljoen H et al: Hydatid disease of the spine. Spine (Phila Pa 1976). 33(22):2479-80, 2008
- El-Arousy MH et al: Cerebrospinal echinococcosis: serodiagnosis using different hydatid cyst fluid antigens. J Egypt Soc Parasitol. 35(1):193-204, 2005
- El Kohen A et al: Multiple hydatid cysts of the neck, the nasopharynx and the skull base revealing cervical vertebral hydatid disease. Int J Pediatr Otorhinolaryngol. 67(6):655-62, 2003
- Hadjipavlou AG et al: Effectiveness and pitfalls of percutaneous transpedicle biopsy of the spine. Clin Orthop. (411):54-60, 2003
- Karadereler S et al: Primary spinal extradural hydatid cyst in a child: case report and review of the literature. Eur Spine J. 11(5):500-3, 2002
- Hassan FO et al: Primary pelvic hydatid cyst: an unusual cause of sciatica and foot drop. Spine. 26(2):230-2, 2001
- Sener RN et al: Multiple, primary spinal-paraspinal hydatid cysts. Eur Radiol. 11(11):2314-6, 2001
- Stabler A et al: Imaging of spinal infection. Radiol Clin North Am. 39(1):115-35, 2001
- Bruschi F et al: Immunochemical and molecular characterization of vertebral hydatid fluid. Scand J Infect Dis. 31(3):322-3, 1999
- Savas R et al: Spinal cord compression due to costal Echinococcus multilocularis. Comput Med Imaging Graph. 23(2):85-8, 1999
- Mazyad MA et al: Spinal cord hydatid cysts in Egypt. J Egypt Soc Parasitol. 28(3):655-8, 1998
- Normelli HC et al: Vertebral hydatid cyst infection (Echinococcus granulosus): a case report. Eur Spine J. 7(2):158-61, 1998
- von Sinner WN et al: Case report 833: Primary spinal echinococcosis (Echinococcus granulosus) of lumbosacral spine with destruction of the left pedicles of L3-5 and extension of a large paraspinal cystic mass into the spinal canal. Skeletal Radiol. 23(3):220-3, 1994
- Sharif HS: Role of MR imaging in the management of spinal infections. AJR Am J Roentgenol. 158(6):1333-45, 1992
- Dernevik L et al: Management of dumbbell tumours. Reports of seven cases. Scand J Thorac Cardiovasc Surg. 24(1):47-51, 1990
- Richards KS et al: Effect of albendazole on human hydatid cysts: an ultrastructural study. HPB Surg. 2(2):105-12; discussion 112-3, 1990
- Charles RW et al: Echinococcal infection of the spine with neural involvement. Spine. 13(1):47-9, 1988
- Bhargava S: Radiology--including computed tomography--of parasitic diseases of the central nervous system. Neurosurg Rev. 6(3):129-37, 1983
- Braithwaite PA et al: Vertebral hydatid disease: radiological assessment. Radiology. 140(3):763-6, 1981
- Kaufman DM et al: Infectious agents in spinal epidural abscesses. Neurology. 30(8):844-50, 1980
- Karvounis PC et al: Intradural spinal echinococcus simulating lumbar disc protrusion. Neurochirurgia (Stuttg). 20(2):58-60, 1977
