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This report describes a 4-year-old boy with progressive lower back pain, bilateral leg weakness and numbness, and urinary incontinence for four months, initially misdiagnosed as rheumatoid arthritis. Thoracolumbar MRI showed multicystic intradural extramedullary lesions compressing the cord from T8 to S2. The child underwent surgery with albendazole and praziquantel, but follow-up revealed recurrence despite early postoperative imaging without residual cysts. Given the morbidity of spinal hydatidosis, prompt recognition and multidisciplinary care are essential to prevent severe complications including cyst expansion and subsequent spinal cord injury.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/primary-spinal-intradural-hydatid-cysts-in-a-child-with-progressive-paraparesis-a-case-report-and-literature-review/460507/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/primary-spinal-intradural-hydatid-cysts-in-a-child-with-progressive-paraparesis-a-case-report-and-literature-review/460507.png","ImageObject",300,407,{"name":92,"@type":93},"Himbo","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":39},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Why was hydatid disease suspected in this child?","Question",{"text":112,"@type":113},"The child had progressive paraparesis symptoms with MRI showing multicystic intradural extramedullary lesions compressing the spinal cord. The authors emphasize hydatid cysts should be suspected for pediatric spinal cord compression in endemic areas.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What diagnostic challenges are highlighted in the report?",{"text":117,"@type":113},"The presentation was nonspecific and the patient was initially misdiagnosed with rheumatoid arthritis. Further deterioration led to neurosurgical evaluation and MRI that identified the characteristic cystic spinal lesions.",{"name":119,"@type":110,"acceptedAnswer":120},"How was the condition treated, and did it recur?",{"text":121,"@type":113},"Treatment included surgery plus medical therapy with albendazole and praziquantel. 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We report an extremely rare case of spinal hydatic cyst with several diagnostic and therapeutic challenges. A 4-year-old boy was referred to our medical center suffering from progressive lower back pain, weakness and numbness in both lower limbs, and urinary incontinence for 4 months. He was initially misdiagnosed with rheumatoid arthritis (RA) . However, as his clinical manifestations deteriorated, a neurosurgical consultation was requested to evaluate other differential diagnoses. Neurological examination revealed bilateral lower extremity weakness accompanied by increased deep tendon reflex (DTR) of the lower extremities. Thoracolumbar magnetic resonance imaging (MRI) demonstrated multicystic lesions, extramedullary intradural, extending from T8 to S2, which caused compression and posterior displacement of the cord. The patient underwent surgery and medical treatment with albendazole and praziquantel. Although early postoperative imaging showed no residual cysts, he experienced recurrence on follow-up. Due to the nonspecific manifestations and high morbidity of spinal hydatidosis, a multidisciplinary approach should be considered to diagnose and manage it. If spinal hydatid disease is diagnosed promptly, it can preclude severe complications, such as cyst expansion and subsequent spinal cord damage.  \n1 | Introduction  \nHydatid disease is a zoonotic infection caused byEchinococcus tapeworm. Although dogs, cats, and livestock are hosts of this parasite [1], humans may become infected through consumption of contaminated food or water. Echinococcus species can involve the liver and lungs of the host in the larval stage [2] . Among the different Echinococcus species, Echinococcus granulosus and E. multilocularis most commonly affect humans [3] .  \nRural and nomadic communities in endemic countries like China, India, Peru, and parts of Africa and the Middle East are mainly affected by this tropical disease. Hydatid disease imposes a substantial disease burden on these regions [4, 5] . At the national level, a meta-analysis by Mahmoudi et al. [6] revealed that the prevalence of hydatid cysts was significantly higher in young villagers and nomads in the North and West of Iran.  \nHydatid disease of the bone is extremely rare, occurring in only 0.5%–2% of the involvements [1] . Approximately half  \nThis is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.  \n© 2026 The Author(s). Clinical Case Reports published by John Wiley & Sons Ltd.  \nClinical Case Reports, 2026; 14:e71823 1 of 10  \n[https://doi.org/10.1002/ccr3.71823](https://doi.org/10.1002/ccr3.71823)  \nKey Clinical Message  \nFor pediatric spinal cord compression in endemic areas, suspect hydatid cysts. Timely diagnosis, rupture-free su","cbCaigtdjXNBWH3I","https://ap.wps.com/l/cbCaigtdjXNBWH3I","pdf",1003770,"English","# Abstract\n# Introduction\n# Case History and Examinations\n# Key Clinical Message","[{\"question\":\"Why was hydatid disease suspected in this child?\",\"answer\":\"The child had progressive paraparesis symptoms with MRI showing multicystic intradural extramedullary lesions compressing the spinal cord. The authors emphasize hydatid cysts should be suspected for pediatric spinal cord compression in endemic areas.\"},{\"question\":\"What diagnostic challenges are highlighted in the report?\",\"answer\":\"The presentation was nonspecific and the patient was initially misdiagnosed with rheumatoid arthritis. Further deterioration led to neurosurgical evaluation and MRI that identified the characteristic cystic spinal lesions.\"},{\"question\":\"How was the condition treated, and did it recur?\",\"answer\":\"Treatment included surgery plus medical therapy with albendazole and praziquantel. Early postoperative imaging showed no residual cysts, but recurrence occurred during follow-up.\"}]","Primary Spinal Intradural Hydatid Cysts in a Child With Progressive Paraparesis - A Case Report and Literature Review | PDF",1790758638,25]