{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T22:09:08Z","timestamp":1769724548601,"version":"3.49.0"},"reference-count":46,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"11","license":[{"start":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T00:00:00Z","timestamp":1757894400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurosurg Case Lessons"],"published-print":{"date-parts":[[2025,9,15]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>\n                      <jats:italic>Echinococcus<\/jats:italic>\n                      species causes hydatid cyst (HC) disease, primarily affecting the liver and lungs. Bone involvement is rare (0.5%\u20132% of cases), with half occurring in the vertebral system. Sacral spine involvement is particularly uncommon and poses diagnostic challenges.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>A 17-year-old male with a history of HC disease presented with low back pain radiating to both lower limbs, claudication, and chronic constipation for 5 years. Imaging revealed a large, multiloculated sacral cyst extending retrorectally and presacrally from S3 to S5, involving the spinal canal, compressing the rectum, and causing sacral erosion. A diagnosis of sacral hydatidosis was made, and the patient was started on albendazole, with surgical excision planned.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>HC disease should be considered in the differential diagnosis of low back pain and constipation, especially in endemic regions. Because of its invasive nature and high recurrence rate, early diagnosis, antiparasitic therapy, and surgical intervention are essential. Proper follow-up is necessary to prevent complications, particularly in atypical presentations.<\/jats:p>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/thejns.org\/doi\/10.3171\/CASE25109\">https:\/\/thejns.org\/doi\/10.3171\/CASE25109<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case25109","type":"journal-article","created":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T00:26:37Z","timestamp":1758587197000},"source":"Crossref","is-referenced-by-count":0,"title":["Sacral hydatid cyst: illustrative case"],"prefix":"10.3171","volume":"10","author":[{"given":"Lana","family":"Maraqa","sequence":"first","affiliation":[{"name":"Medical Research Club, Al Quds University Faculty of Medicine, Jerusalem, Palestine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruba","family":"Najib","sequence":"additional","affiliation":[{"name":"Medical Research Club, Al Quds University Faculty of Medicine, Jerusalem, Palestine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-3721-1926","authenticated-orcid":true,"given":"Majd","family":"Mohsen","sequence":"additional","affiliation":[{"name":"Medical Research Club, Al Quds University Faculty of Medicine, Jerusalem, Palestine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ismail","family":"Abudaya","sequence":"additional","affiliation":[{"name":"Al Quds University Faculty of Medicine, Jerusalem, Palestine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4977-4114","authenticated-orcid":true,"given":"Basel","family":"Zaben","sequence":"additional","affiliation":[{"name":"Medical Research Club, Al Quds University Faculty of Medicine, Jerusalem, Palestine"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"1","key":"bib1","series-title":"Am J Surg Pathol","first-page":"94","article-title":"Echinococcosis: unexpected occurrence and the diagnostic contribution of routine histopathology","volume":"41","author":"Taxy","year":"2017","unstructured":"Taxy JBGibson WEKaufman MW.Echinococcosis: unexpected occurrence and the diagnostic contribution of routine histopathology. Am J Surg Pathol. 2017;41(1):94-100."},{"issue":"2","key":"bib2","series-title":"Int J Infect Dis","first-page":"125","article-title":"Echinococcosis: a review","volume":"13","author":"Moro","year":"2009","unstructured":"Moro PSchantz PM.Echinococcosis: a review. Int J Infect Dis. 2009;13(2):125-133."},{"issue":"7","key":"bib3","series-title":"Cureus","first-page":"e63713","article-title":"Hydatid cyst or echinococcosis: a comprehensive review of transmission, clinical manifestations, diagnosis, and multidisciplinary treatment","volume":"16","author":"Badwaik","year":"2024","unstructured":"Badwaik NGharde PShinde RKTayade HNavandhar PSPatil M.Hydatid cyst or echinococcosis: a comprehensive review of transmission, clinical manifestations, diagnosis, and multidisciplinary treatment. Cureus. 2024;16(7):e63713."},{"issue":"2","key":"bib4","series-title":"J Neurosci Rural Pract","first-page":"61","article-title":"Hydatid disease of the spine","volume":"1","author":"Bhake","year":"2010","unstructured":"Bhake AAgrawal A.Hydatid disease of the spine. J Neurosci Rural Pract. 2010;1(2):61-62."},{"key":"bib5","series-title":"J Orthop","first-page":"157","article-title":"Magnetic resonance imaging features and classification of intraspinal echinococcosis","volume":"55","author":"Chang","year":"2024","unstructured":"Chang YHe XLiu WGuo H.Magnetic resonance imaging features and classification of intraspinal echinococcosis. J Orthop. 2024;55:157-162."},{"issue":"2","key":"bib6","series-title":"J Spinal Disord Tech","first-page":"180","article-title":"Diagnostic pitfalls of spinal echinococcosis","volume":"20","author":"Song","year":"2007","unstructured":"Song XLiu DWen H.Diagnostic pitfalls of spinal echinococcosis. J Spinal Disord Tech. 2007;20(2):180-185."},{"issue":"9","key":"bib7","series-title":"PLoS Negl Trop Dis","first-page":"e2458","article-title":"Spinal cystic echinococcosis\u2014a systematic analysis and review of the literature: part 2. Treatment, follow-up and outcome","volume":"7","author":"Neumayr","year":"2013","unstructured":"Neumayr ATamarozzi FGoblirsch SBlum JBrunetti E.Spinal cystic echinococcosis\u2014a systematic analysis and review of the literature: part 2. Treatment, follow-up and outcome. PLoS Negl Trop Dis. 2013;7(9):e2458."},{"issue":"2","key":"bib8","series-title":"J Korean Neurosurg Soc","first-page":"209","article-title":"Spinal hydatid cyst disease: challenging surgery\u2014an institutional experience","volume":"62","author":"Caglar","year":"2019","unstructured":"Caglar YSOzgural OZaimoglu MSpinal hydatid cyst disease: challenging surgery\u2014an institutional experience. 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J Orthop Case Rep. 2021;11(11):22-26."},{"key":"bib20","series-title":"World Neurosurg","first-page":"407","article-title":"Spinal hydatid cyst disease","volume":"108","author":"Gezercan","year":"2017","unstructured":"Gezercan Y\u00d6kten AI\u00c7avu\u015f GA\u00e7\u0131k VBilgin E.Spinal hydatid cyst disease. World Neurosurg. 2017;108:407-417."},{"issue":"1","key":"bib21","series-title":"Surg Neurol","first-page":"53","article-title":"Spinal hydatid cysts","volume":"21","author":"Pamir","year":"1984","unstructured":"Pamir MNAkalan NOzgen TErbengi A.Spinal hydatid cysts. Surg Neurol. 1984;21(1):53-57."},{"issue":"271","key":"bib22","series-title":"Clin Orthop Relat Res","first-page":"164","article-title":"Echinococcal infestation of the spine in North America","author":"Rao","year":"1991","unstructured":"Rao SParikh SKerr R.Echinococcal infestation of the spine in North America. 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Int J Infect Dis. 2009;13(2):125-133."},{"issue":"7","key":"bib3","series-title":"Cureus","first-page":"e63713","article-title":"Hydatid cyst or echinococcosis: a comprehensive review of transmission, clinical manifestations, diagnosis, and multidisciplinary treatment","volume":"16","author":"Badwaik","year":"2024","unstructured":"Badwaik NGharde PShinde RKTayade HNavandhar PSPatil M.Hydatid cyst or echinococcosis: a comprehensive review of transmission, clinical manifestations, diagnosis, and multidisciplinary treatment. Cureus. 2024;16(7):e63713."},{"issue":"2","key":"bib4","series-title":"J Neurosci Rural Pract","first-page":"61","article-title":"Hydatid disease of the spine","volume":"1","author":"Bhake","year":"2010","unstructured":"Bhake AAgrawal A.Hydatid disease of the spine. J Neurosci Rural Pract. 2010;1(2):61-62."},{"key":"bib5","series-title":"J Orthop","first-page":"157","article-title":"Magnetic resonance imaging features and classification of intraspinal echinococcosis","volume":"55","author":"Chang","year":"2024","unstructured":"Chang YHe XLiu WGuo H.Magnetic resonance imaging features and classification of intraspinal echinococcosis. J Orthop. 2024;55:157-162."},{"issue":"2","key":"bib6","series-title":"J Spinal Disord Tech","first-page":"180","article-title":"Diagnostic pitfalls of spinal echinococcosis","volume":"20","author":"Song","year":"2007","unstructured":"Song XLiu DWen H.Diagnostic pitfalls of spinal echinococcosis. J Spinal Disord Tech. 2007;20(2):180-185."},{"issue":"9","key":"bib7","series-title":"PLoS Negl Trop Dis","first-page":"e2458","article-title":"Spinal cystic echinococcosis\u2014a systematic analysis and review of the literature: part 2. 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J Korean Neurosurg Soc. 2019;62(2):209-216."},{"issue":"5","key":"bib9","series-title":"Int J Surg","first-page":"1136","article-title":"The SCARE 2023 guideline: updating consensus Surgical Case Report (SCARE) guidelines","volume":"109","author":"Sohrabi","year":"2023","unstructured":"Sohrabi CMathew GMaria NThe SCARE 2023 guideline: updating consensus Surgical Case Report (SCARE) guidelines. Int J Surg. 2023;109(5):1136-1140."},{"issue":"2","key":"bib10","series-title":"Parasitol Res","first-page":"107","article-title":"Human cystic echinococcosis in the West Bank of Palestine: surgical incidence and seroepidemiological study","volume":"88","author":"Abu-Hasan","year":"2002","unstructured":"Abu-Hasan NDaragmeh MAdwan KAl-Qaoud KAbdel-Hafez SK.Human cystic echinococcosis in the West Bank of Palestine: surgical incidence and seroepidemiological study. Parasitol Res. 2002;88(2):107-112."},{"issue":"2","key":"bib11","series-title":"Clin Microbiol Rev","first-page":"e00075-18","article-title":"Echinococcosis: advances in the 21st century","volume":"32","author":"Wen","year":"2019","unstructured":"Wen HVuitton LTuxun TEchinococcosis: advances in the 21st century. Clin Microbiol Rev. 2019;32(2):e00075-18."},{"key":"bib12","article-title":"Echinococcosis","author":"World Health Organization","unstructured":"World Health Organization.Echinococcosis. WHO; 2021. Accessed March 15, 2025. https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/echinococcosis"},{"issue":"2","key":"bib13","series-title":"Am J Trop Med Hyg","first-page":"313","article-title":"Epidemiology of parasitic infections in the West Bank and Gaza Strip, Palestine","volume":"102","author":"Hamarsheh","year":"2020","unstructured":"Hamarsheh OAmro A.Epidemiology of parasitic infections in the West Bank and Gaza Strip, Palestine. 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Eur Spine J. 2013;22(suppl 3):S329-S336."},{"issue":"9","key":"bib16","series-title":"PLoS Negl Trop Dis","first-page":"e2450","article-title":"Spinal cystic echinococcosis\u2014a systematic analysis and review of the literature: part 1. Epidemiology and anatomy","volume":"7","author":"Neumayr","year":"2013","unstructured":"Neumayr ATamarozzi FGoblirsch SBlum JBrunetti E.Spinal cystic echinococcosis\u2014a systematic analysis and review of the literature: part 1. Epidemiology and anatomy. PLoS Negl Trop Dis. 2013;7(9):e2450."},{"issue":"5","key":"bib17","series-title":"Clin Case Rep","first-page":"e7244","article-title":"Spinal hydatid cyst initially diagnosed as spinal tumor: a case report and review of the literature","volume":"11","author":"Zali","year":"2023","unstructured":"Zali AShahmohammadi MBiazar BHMasoumi NSamieefar NAkhlaghdoust M.Spinal hydatid cyst initially diagnosed as spinal tumor: a case report and review of the literature. Clin Case Rep. 2023;11(5):e7244."},{"issue":"5","key":"bib18","series-title":"J Neurosurg Pediatr","first-page":"526","article-title":"A sacral hydatid cyst mimicking an anterior sacral meningocele","volume":"8","author":"Hemama","year":"2011","unstructured":"Hemama MLasseini ARifi LA sacral hydatid cyst mimicking an anterior sacral meningocele. J Neurosurg Pediatr. 2011;8(5):526-529."},{"issue":"11","key":"bib19","series-title":"J Orthop Case Rep","first-page":"22","article-title":"Novel multimodal treatment regimen for the management of primary sacrococcygeal cystic echinococcosis","volume":"11","author":"Annamalai","year":"2021","unstructured":"Annamalai SMuthu SThakur ARamakrishnan E.Novel multimodal treatment regimen for the management of primary sacrococcygeal cystic echinococcosis. J Orthop Case Rep. 2021;11(11):22-26."},{"key":"bib20","series-title":"World Neurosurg","first-page":"407","article-title":"Spinal hydatid cyst disease","volume":"108","author":"Gezercan","year":"2017","unstructured":"Gezercan Y\u00d6kten AI\u00c7avu\u015f GA\u00e7\u0131k VBilgin E.Spinal hydatid cyst disease. World Neurosurg. 2017;108:407-417."},{"issue":"1","key":"bib21","series-title":"Surg Neurol","first-page":"53","article-title":"Spinal hydatid cysts","volume":"21","author":"Pamir","year":"1984","unstructured":"Pamir MNAkalan NOzgen TErbengi A.Spinal hydatid cysts. Surg Neurol. 1984;21(1):53-57."},{"issue":"271","key":"bib22","series-title":"Clin Orthop Relat Res","first-page":"164","article-title":"Echinococcal infestation of the spine in North America","author":"Rao","year":"1991","unstructured":"Rao SParikh SKerr R.Echinococcal infestation of the spine in North America. 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