Primary spinal echinococcosis causing paraplegia: case report with MR and pathologic correlation.

A 65-year-old man had a tender soft-tissue swelling in the right paraspinal area at the T1 0-T11 level and paraplegia of 1 0 days duration. Chest radiograph showed healed tubercular lesions in the upper right lung. Vertebral bodies and paravertebral areas were reported to be normal. Blood and sputum cultures for acid-fast bacilli were negative. Metrizamide myelography showed a complete block at the T9 level. MR imaging showed a multiloculated cystic mass in the extradural space at T9-T11 on the right side compressing the spinal cord (Fig . 1 ). Extradural spread of the lesion was seen through a widened right neural foramen at TB-T9 extending into the muscle plane up to the L 1 level like a "bunch of grapes. " Various amounts of hyperintensity with intervening areas of low intensity were observed in the multiloculated cysts on T2-weighted images. Surgery for decompression of the thoracic spine showed a multicystic mass containing clear fluid within the cysts. The lesion was localized in the extradural space at T9-T11 and extended into the muscle planes to the L 1 level on the right. Gross pathologic and histologic examinations confirmed the diagnosis of hydatid disease. Bronchoscopy done subsequently excluded pulmonary hydatidosis.