Isolated Extradural Hydatid Cyst of the Dorsal Spine: A Case Report

Vertebro-medullary hydatidosis is a rare disease, and isolated extradural spinal involvement is exceptional, particularly in children, making diagnosis and management challenging. We report the case of a 12-year-old child from a rural area, with no significant medical history, who presented with progressive dorsolumbar pain for three months, followed by heaviness of both lower limbs and sphincter dysfunction. Clinical examination revealed a dorsal spinal cord compression syndrome. Magnetic resonance imaging (MRI) of the dorsolumbar spine demonstrated a well-defined, bilobed anterior extradural cystic lesion, predominantly right-sided, centered at T12, appearing hypointense on T1-weighted images and hyperintense on T2-weighted images, causing posterior displacement and compression of the spinal cord without associated bone involvement. Computed tomography confirmed an intraspinal epidural lesion without vertebral destruction. Laboratory tests were unremarkable except for mild eosinophilia, and no other hydatid localizations were identified. An emergency surgical decompression was performed via posterior laminectomy with complete excision of the cyst. Histopathological examination confirmed the diagnosis of a hydatid cyst. Postoperatively, the patient received albendazole therapy according to the national protocol. The postoperative course was favorable, with complete neurological recovery after 11 months of follow-up. This case highlights the rarity of primary isolated extradural spinal hydatid cysts, the crucial role of MRI in diagnosis, and the importance of early combined surgical and medical treatment, which offers a good neurological prognosis.