Laparoscopic transdiaphragmatic approach to a thoracic paravertebral hydatid cyst presenting with compression myelopathy.

Kumar, Saket; Kumar, Abhay; Kumar, Mukesh; Parween, Rana

An elderly gentleman presented with heaviness over the right side of the chest, lower back pain and difficulty in walking for the last 6 months. He also reported of progressive weakness of the left leg associated with tingling and numbness for 2 months. Imaging studies revealed a large hydatid cyst in the right thoracic cavity compressing the spinal cord. The patient was prescribed a 14-day course of albendazole therapy. He underwent laparoscopic transdiaphragmatic deroofing and evacuation of the cyst. Postoperative recovery was uneventful. The patient started showing symptom relief from day 1 of surgery and by day 3, his right leg strength and sensation recovered remarkably. Echinococcal cyst is a zoonotic disease that can affect any part of the body. Vertebral involvement and spinal cord compression is a rare manifestation of echinococcal disease. Such cases pose diagnostic and therapeutic challenges and require a multidisciplinary approach to treat them successfully.