Primary hydatid cyst of pineal region of brain: A case report from Saudi Arabia

Preoperative diagnosis of cerebral echinococcosis in an unusual location is always difficult. Nonetheless, this possibility should be kept in mind in all cystic lesions of the brain. Although total excision of the cyst without rupture is a time - tested treatment, but in order to prevent recurrence, adjuvant medical treatment should also be started. Albendazole, mebenadazole and praziquental are commonly used drugs. Albendazole is a drug of choice. Its usual dose for adults is 400 mg twice daily. Exact duration of treatment is still uncertain, but it should not be <6 months. This case report shows primary presentation of hydatid cyst in the pineal region which later disseminated intracranially. However complete excision of the cyst at site of recurrence, combined with medical treatment, proved quite successful. Patient was found recurrence free 3 years after surgery. Last but not least, endoscopic third ventriculostomy and biopsy should be performed very carefully in cystic lesions of posterior third ventricular region.