Author(s)

Sebastián Barber-Millet, Salvador Pous-Serrano, Javier Maupoey-Ibáñez, Marta Trallero-Anoro, Erick Montilla-Navarro, Rosana Palasí-Jiménez

Department of Surgery, La Fe Hospital, Valencia, Spain.

Introduction: Hydatidosis is caused by the larvae of the cestode Echinococcus 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.

Presacralhydatid Cyst, Echinococcosis, Sciatica, Combined Surgical Approach

Barber-Millet, S. , Pous-Serrano, S. , Maupoey-Ibáñez, J. , Trallero-Anoro, M. , Montilla-Navarro, E. and Palasí-Jiménez, R. (2014) Presacralhydatid Cyst: An Exceptional Presentation. Surgical Science, 5, 384-388. doi: 10.4236/ss.2014.59062.