Primary costovertebral hydatidosis revealed by compressive myelitis: a case report.

Osseous hydatidosis is a rare manifestation of echinococcosis, accounting for a small proportion of hydatid disease cases, with spinal involvement representing the most severe form due to the risk of neurological complications. We report the case of a 32-year-old woman living in a rural area who presented with progressive paraplegia secondary to spinal cord compression, leading to the diagnosis of isolated primary costovertebral hydatidosis. Spinal magnetic resonance imaging revealed an extensive multivesicular lesion involving the thoracic spine with extradural spinal cord compression and displacement of the adjacent hemithorax without pulmonary parenchymal involvement. Emergency surgical decompression with cyst excision was performed, and histopathological examination confirmed the diagnosis. Postoperative antiparasitic treatment with albendazole was initiated, resulting in a favorable neurological outcome. This case highlights the diagnostic challenges, imaging features, and therapeutic management of this exceptional localization and underlines the importance of early diagnosis to prevent irreversible neurological sequelae.