TITLE:
Presacralhydatid Cyst: An Exceptional Presentation
AUTHORS:
Sebastián Barber-Millet, Salvador Pous-Serrano, Javier Maupoey-Ibáñez, Marta Trallero-Anoro, Erick Montilla-Navarro, Rosana Palasí-Jiménez
KEYWORDS:
Presacralhydatid Cyst, Echinococcosis, Sciatica, Combined Surgical Approach
JOURNAL NAME:
Surgical Science,
Vol.5 No.9,
September
5,
2014
ABSTRACT: Introduction: Hydatidosis
is caused by the larvae of the cestodeEchinococcus
granulosus. Liver and lung are the most frequent locations. We report a
rare case of a primary hydatid disease location in pre-sacral space. Clinic
case: A 64-year-old male patient who consulted due to right gluteal area pain
radiating to outer side of the right leg. Physical examination showed a
positive Lasègue with hypoesthesia in right L4 L5 S1 territories, with loss of
strength in S1. The x-ray showed L3 vertebral wedging and a lumbar lordosis
rectification. Laboratory tests and tumor markers were negative. Endorectal
ultrasonography described a multilobulatedpresacral cystic tumor. Magnetic
resonance imaging (MRI) showed a 16 × 10 × 11 cm retro rectal mass. Due to
uncertain diagnosis, surgery was performed, with previous albendazol
administration and surgical field protection with 20% hypertonic saline
solution. Combined approach (laparotomy + Kraske incision) was realized.
Postoperative course was uneventful. The patient remained asymptomatic 36
months after surgery. Summary: Presacralhydatid cysts are rare entities, but
must be considered in differential diagnosis of space-occupying lesions in
presacral region. Surgery is treatment of choice, and medical treatment may be
useful to prevent recurrences.