Non-Surgical Exceptional Management of Inoperable Hydatidosis with Radiotherapy: Case Report and Review of Literature

ABSTRACT. Vertebral hydatidosis is a rare and severe form of echinococcosis with limited treatment options when surgery is not feasible. Radiotherapy has traditionally been considered ineffective, but emerging evidence suggests a potential role in disease control. We report the case of a 71-year-old man with chronic vertebral hydatidosis affecting fifth lumbar vertebra and the sacrum, causing nerve compression and soft tissue extension. Because of the inoperability of the lesion, the patient underwent radiology-guided drainage, followed by radiotherapy (54 gray in 27 fractions), resulting in significant clinical and radiological improvement, with no recurrence after 1 year. This case highlights radiotherapy as a promising adjunctive treatment in inoperable hydatidosis. The combination of radiotherapy with minimally invasive techniques may offer an effective therapeutic alternative. Further research is needed to establish its role in the management of complex cases.