Alveolar echinococcosis (AE) is a rare parasitic disease caused by the larv
al stage of Echinococcus multilocularis. It differs from cystic echinococco
sis caused by Echinococcus granulosus. The main endemic areas of AE are Ala
ska, Canada, Japan, and parts of Europe. Hepatic involvement invariably occ
urs, but it is unusual for bone to be affected. We report the case of a wom
an presenting with a long history of pain, cachexia, morning stiffness, and
biological signs of inflammation. Radiographs and principally magnetic res
onance images were nonspecific, showing inhomogeneous osteolysis of vertebr
al bodies without loss of intervertebral disc height but with a paravertebr
al mass. The diagnosis ultimately relied on pathological examination, which
showed an anhistic laminated membrane colored in red with Periodic-Acid-Sc
hiff surrounding a central cavity, and by the serologic testing, principall
y ELISA Em2+ method, which allowed a 97% specificity and 99% specificity in
the diagnosis of AE.
AE involving bone is an uncommon condition. Although magnetic resonance ima
ging can be used to search for local complications, the features it detects
are, like those revealed by radiographs, nonspecific and can, lead to A-E
being misdiagnosed as neoplasm or tuberculous osteitis. When a patient pres
ents with suspected AE in an endemic area, the diagnosis can be achieved by
serological testing alone (Western blot and Em2+ ELISA), thereby avoiding
the need for biopsy.