Presentation
Persistent upper dorsal pain.
Patient Data
Left paravertebral multiloculated cystic mass with peripheral calcification at T3-T4 level measuring 43 x 37 x 35 mm with osteolysis of the adjacent costovertebral joint of the 4th rib as well as the left aspect of T3 and T4 vertebral bodies and pedicles. There is an extension to the anterior epidural space through the adjacent T3-T4 foramina, compressing the spinal cord. Narrowing of T3-T4 disc space with irregularity and sclerosis of the vertebral endplates.
Hepatic hydatid cyst with a calcified wall in the segment 5 measuring 54 x 48 x 28 mm as well as small hemangioma of segment 7 (known).
Lungs are clear (not shown).
Case Discussion
CT features of a paravertebral hydatid cyst extending to the spinal canal with narrowing of the T3-T4 disc space, mimicking a tuberculous spondylodiscitis in a patient with a hepatic hydatid cyst. An MRI of the spinal cord was requested.
The differential diagnosis of tuberculous spondylodiscitis should include spinal hydatid disease especially in patients from endemic countries.
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