Primary cervical hydatid cyst: A rare case report

Pathological Fracture of the Tibia Due to Lytic Bone Lesion Caused by Hydatidosis with Absence of Systemic Involvement: A Case Report and Review of Literature

BACKGROUND

This report raises attention to hydatidosis in bone as a neglected lytic osseous disease.

CASE PRESENTATION

The authors reported a case of a 49-year-old female who presented with pain and swelling in the right upper leg. X-ray suggested a lytic lesion in the right proximal tibia. Adenocarcinoma metastasis was suspected, yet, the investigations revealed negative Positron emission tomography (PET) scan metastatic work-up and negative alpha-fetoprotein, Cancer Antigen (CA) 15.3, CA 19.9, CA125, and Carcinoembryonic antigen (CEA). The histopathological evaluation of the extracted core biopsy showed a granulomatous reaction with reactive fibrosis. Immune reactive CD68 cells were recorded in the epithelioid macrophages and foreign body giant cells. Four months later, the patient was presented with a pathological fracture in the upper right leg. Surprisingly, the histopathological evaluation of the Hematoxylin and Eosin sections and the cytological assessment reported pathognomonic structures for hydatid in the form of foreign body giant cells engulfing laminated hyaline eosinophilic material and a scarce number of hooks. The absence of cellular atypia excluded malignancy. Periodic acid schiff highlighted the pathognomonic laminated fragments and granulation tissue. Masson trichrome staining emphasized collagen deposition.

CONCLUSION

Osseous hydatidosis is a neglected disease that may mimic lytic bone tumors. Vague radiological features and scarce parasite-derived structure in histopathology may misinterpret the disease. Raising attention to bone hydatidosis among clinicians is recommended.

A Comprehensive Analysis of Echinococcus granulosus Infections in Children and Adolescents: Results of a 7-Year Retrospective Study and Literature Review

Cystic echinococcosis (CE) is a neglected tropical parasitic disease linked with significant social and economic burdens worldwide. The scientific community has minimal information on echinococcosis in Romanian people, and hospital medical records are the only sources that may be used to investigate its status. A 7-year retrospective clinical study on pediatric patients with CE from Southeast Romania was performed, and 39 children and adolescents were included, aged 2-15 years old. They were hospitalized with cystic echinococcosis in the Pediatric Department and Pediatric Surgery Department of Constanta County Clinical Emergency Hospital "St. Apostle Andrew" between 1 January 2017 and 1 October 2024. Twenty-nine (74.36%) pediatric patients came from rural zones, and 10 (25.64%) had urban residences. In total, 28 children (71.79%) had contact with four different animals (dogs, goats, pigs, and sheep); only four were from urban zones, and they had contact only with dogs. Data regarding the length of hospital stay, cyst location, and complications were collected and analyzed. According to the medical files, the diagnosis was established using imaging techniques and serological tests for CE. IgE and IgG reported appreciable variations in correlation with all parameters, and significant differences (p < 0.05) were recorded. IgE levels considerably increased in cases of no animal contact, pulmonary involvement, complications, surgical treatment, and multiple hospitalizations. Moderate IgE values were recorded in cases of urban residences, pig and sheep contact, and hepatic involvement. The IgG concentration considerably increased with sheep contact and moderately increased in cases of rural zones, hepatic involvement, complications, and surgical treatment. The results show that incidental discovery, symptoms, complications, multiple dissemination, pulmonary involvement, and dog and pig contact increase the hospitalization time. Extensive data analysis supports our results. Our findings highlight the complexity of managing E. granulosus infections in children and evidence the importance of a multidisciplinary approach, combining early diagnostic tools, tailored medical therapy, and careful surgical intervention when necessary.

Case Report of a Hidden Intruder-Extremely Rare Presentation of Hydatidosis as a Nuchal Tumoural Mass

Introduction: The parasitic tapeworm impersonated by the larvae of Echinococcus granulosus represents the aetiology of the hydatid pathology. The predilect site of invasion is the liver, but there are other cases of different localization all over the body, regardless of the type of invaded tissue. Soft tissue hydatidosis can be a real challenge for the clinician in terms of the diagnosis, and it might generate various complications such as anaphylactic shock. The aim of the present work is to illustrate a unique case of primary hydatidosis located in the nuchal region. Case Report: We report the case of a 68-year-old male patient, a zootechnic, who presented at the hospital with a tumoural mass (dimension: about 12/10 cm) located in the nuchal region. The complex approach needed consisted of surgical therapy along with histopathological confirmation of the diagnostic and antiparasitic medication, which led to a complete recovery with a low probability of recurrence. Discussion: Encounters with patients with primary soft tissue hydatidosis are exceptionally rare, but the surgeon must take into consideration this clinical diagnosis, especially for patients located in an endemic region with occupations that might have exposed the patient to this type of parasite.

Echinococcal Disease of the Fallopian Tube as a Rare Cause of Primary Subfertility

Echinococcosis is a significant zoonotic infection caused by Echinococcus granulosus, which has a worldwide distribution. In India, the annual incidence varies from one to 200 in 100,000 people. The liver and lungs are often affected, making diagnosis difficult when infections occur in uncommon areas. We report a case of a hydatid cyst in the fallopian tube, which presented as subfertility and was confirmed by radiological imaging.

Primary intramuscular thigh hydatid cyst: A case report

INTRODUCTION AND IMPORTANCE

Hydatid cyst is a parasitic infection caused by Echinococcus granulosis. It mostly involves the liver and lungs; however, muscle involvement is an uncommon event. The diagnosis of such cystic masses is still a challenge due to the presence of more common pathological conditions in soft tissue. Imaging is useful and can identify a definitive diagnosis.

CASE PRESENTATION

We present a case of a 32-year-old woman with history of close contact with dogs and cats, who complained of an isolated swelling in the right upper thigh growing gradually over a period of 3 years. Ultrasound reported intramuscular hydatid cyst in the right thigh. Hydatid cyst was completely excised. The outcome was good, with no recurrence in one year.

CLINICAL DISCUSSION

Ultrasonography is an excellent and cost-effective imaging modality with a high negative predictive value in the evaluation of palpable superficial soft-tissue masses and hydatid cysts.

CONCLUSION

Isolated intramuscular hydatid cyst is rarely reported, even in endemic areas of the disease, so the diagnosis should be considered in any cystic masses of soft tissue, particularly in subjects from high-endemic zones. Although the treatment of choice in such cases is surgical excision but prevention is more favorable to fight against hydatid disease.