Subcutaneous extension of a large psoas muscle Echinococcus cyst

Past and Present of Diagnosis of Echinococcosis: A Review (1999-2021)

The larval forms of taeniid cestodes belonging to the genus Echinococcus are the source of the zoonotic infection known as echinococcosis. Alveolar and cystic echinococcosis are caused by Echinococcus multilocularis and Echinococcus granulosus (s. s) respectively. It is endemic in several regions of the world. In this systematic review, we describe diagnosis, and the species (human, canids, livestock, and small rodents) affected by cystic (CE) and alveolar echinococcosis (AE). From 1999 to 2021, we searched the online directory through PubMed, SCOPUS, Web of Science, and google scholar. Among the 37,700 records found in the online databases, 187 publications met our eligibility requirements. The majority of investigations employed a range of diagnostic methods, such as ELISA, imaging, copro-PCR, necropsy or arecoline hydrobromide purgation, morphological cestode confirmation, and fecal sieving/flotation to detect and confirm Echinococcus infection. ELISA was the most commonly used method followed by PCR, and imaging. The research team retrieved data describing the incidence or assessment of the diagnostic test for E. multilocularis in humans (N = 99), canids (N = 63), small ruminants (N = 13), large ruminants (N= 3), camel (N= 2), pigs (N=2) and small mammals (N= 5). This study was conducted to explore the diagnostic tools applied to detect echinococcosis in humans as well as animals in prevalent countries, and to report the characteristic of new diagnostic tests for disease surveillance. This systematic review revealed that ELISA (alone or in combination) was the most common method used for disease diagnosis and diagnostic efficacy and prevalence rate increased when recombinant antigens were used. It is highly recommended to use combination protcols such as serological with molecular and imaging technique to diagnose disease. Our study identified scarcity of data of reporting echinococcosis in humans/ animals in low-income or developing countries particularly central Asian countries. Study reports in small rodents indicate their role in disease dissemination but real situation in these host is not refected due to limited number of studies. Even though echinococcosis affects both public health and the domestic animal sector, therefore, it is important to devise new and strengthe implementation of the existing monitoring, judging, and control measures in this estimate.

A case report of primary multiple hydatid cysts of psoas muscle: An exceptional location

The psoas muscle localization is even more exceptional when they are multiple. The clinical and radiological features were often misleading. This case report aimed to highlight the difficulties of radiological diagnosis and the dilemma of choosing the best operative approach. A 27 year-old-men with no past medical history has been consulted for right down abdominal quadrant pain. Physical examination revealed a painless abdominal mass. An abdominal CT Scan concluded with the presence of two multisectional cystic lesions. The first cystic lesion had an exophytic development, and the second cystic lesion was in the posterior and lateral sides of the psoas muscle. The hemaglutinin reaction and the Western blot were positive. A laparotomy was done. The exploration objective is a first psoas muscle hydatid cyst of 5 cm with an exophytic development just behind the vermiform appendix with a second hydatid cyst of 15 cm. The puncturing and aspiration of the cystic fluid bring a clear hydatid fluid. Parasitic sterilization was performed by injecting a scoliosis solution, hypertonic serum, into the cystic lesion. After ten minutes, we resected the two cystic lesions' protruding dome. We have aspirated the fluid and all the daughter hydatid cysts from the two hydatid cysts. The postoperative follow-up was uneventful. The primary hydatid cyst of the psoas muscle often causes a problem of its hydatid nature. Surgery remains the only curative treatment. It avoids the risk of complications such as peritoneal rupture, which can modify the surgical therapeutic strategy.

Psoas Hydatid Cyst in Children: A Rare Localization about a Case

Introduction

The development of hydatid cysts in the muscle is rare, and it is even rarer in children. We report the case of a 9-year-old child treated in pediatric orthopedics department at the University Hospital of Marrakech for a hydatid cyst psoas muscle revealed by lameness.

Result

The child was consulted for painless and afebrile lameness of the left hip evolving since 3 months. The clinical examination finds a mass of the left flank. Investigations based on the abdominal ultrasound in first intention showed a hydatid cyst depending on the left psoas muscle. Pelvic CT and abdominal MRI were able to confirm the diagnosis and allowed a better study of the cyst neighboring elements. The drainage of the cyst followed by pericystectomy after evacuation of the vesicles contained in the cyst was done as radical treatment.

Conclusion

The hydatid cyst of the psoas is a rare entity in the child requiring a good radiological study of the cyst as well as its neighboring elements to propose the most adapted surgery.

Subcutaneous extension of a large diaphragmatic hydatid cyst

A 53-year-old male patient with a large hydatid cyst of the left hemidiaphragm and smaller secondary cysts located in the left thoracic cavity and upper left abdominal quadrant presented with two progressively enlarging lipoma-like masses in the left hypochondrium and under the left scapulae respectively. Total excision of all the cysts was performed through a bilateral subcostal incision, with the left hemidiaphragm near totally excised and replaced by a synthetic bilayer mesh.