Unmasking the mimic: vertebral alveolar echinococcosis diagnosed by metagenomic next-generation sequencing.

A Siberian woman in her forties presented to a public hospital in northeastern Germany with chronic back pain and a paravertebral mass, initially misdiagnosed as spinal tuberculosis. Repeated biopsies and metagenomic next-generation sequencing (mNGS) ultimately confirmed vertebral alveolar echinococcosis. Haplotype analysis revealed a novel Asian-cluster variant, supporting the presumed origin of infection.