Alveolar echinococcosis presenting with simultaneous cerebral and spinal involvement.

A 37-year-old Tibetan shepherdess presented with headache and weakness of the lower limbs for 10 months. Examination disclosed a positive straight-leg-raising test. Neuroimaging showed a heterogeneous mass in the left temporal lobe (figure 1) and an intradural mass in the lumbosacral canal with L4 vertebral body destruction (figure 2). Chest and abdominal CT scans were negative. Two operations yielded a tissue diagnosis of alveolar echinococcosis and postoperative albendazole therapy was started. Simultaneous involvement of brain and the spinal cord in primary extrahepatic alveolar echinococcosis is rare. Early diagnosis and radical surgery followed by continuous benzimidazole treatment are crucial.