title: Primary extrahepatic alveolar echinococcosis of the lumbar spine and the psoas muscle.
abstract: Alveolar echinococcosis (AE) of human being caused by Echinococcus multilocularis is a rare but important zoonosis especially in tempered zones of middle Europe and Northern America with endemic character in many countries. Due to the long incubation period, various clinical manifestations, critical prognosis, and outcome AE presents a serious and severe disease. The primary focus of infection is usually the liver. Although secondary affection of visceral organs is possible extrahepatic AE is highly uncommon. Moreover, the involvement of bone and muscle presents with an even lower incidence. In the literature numerous cases on hepatic AE have been reported. However, extrahepatic AE involving bones and/or muscles was described very rarely. We report a case of an 80-year-old man with primary extrahepatic alveolar Echinococcosis of the lumbar spine and the psoas muscle. The etiology, diagnosis, differential diagnoses, treatment options and outcome of this rare disease are discussed in context with the current literature.
authors.affiliation: Department of Orthopaedics and Traumatology, Technische Universität München, Klinikum Rechts der Isar, Ismaninger Str 22, D-81675 Munich, Germany.
authors.forename: Manuel
authors.initials: M
authors.lastname: Nell
authors.forename: Rainer H
authors.initials: RH
authors.lastname: Burgkart
authors.forename: Guntmar
authors.initials: G
authors.lastname: Gradl
authors.forename: Rüdiger
authors.initials: R
authors.lastname: von Eisenhart-Rothe
authors.forename: Christoph
authors.initials: C
authors.lastname: Schaeffeler
authors.forename: Dennis
authors.initials: D
authors.lastname: Trappe
authors.forename: Clarissa Prazeres
authors.initials: CP
authors.lastname: da Costa
authors.forename: Reiner
authors.initials: R
authors.lastname: Gradinger
authors.forename: Chlodwig
authors.initials: C
authors.lastname: Kirchhoff
mesh_terms: D000369:Aged, 80 and over; D000818:Animals; D003937:Diagnosis, Differential; D004443:Echinococcosis; D004444:Echinococcosis, Hepatic / Q000175:diagnosis / Q000469:parasitology / Q000473:pathology / Q000601:surgery; D048210:Echinococcus multilocularis / Q000302:isolation & purification*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D010388:Pelvis / Q000000981:diagnostic imaging; D016658:Psoas Muscles / Q000469:parasitology / Q000473:pathology*; D011860:Radiography, Abdominal; D013131:Spine / Q000469:parasitology / Q000473:pathology*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome