[Isolated gluteal hydatid cyst]

Primary Soft Tissue Hydatid Cysts

OBJECTIVE

Hydatid cyst disease is a helminthic infection caused by Echinococcus granulous, which is encountered with cysts in many organs, especially the liver and lungs. Soft tissue and intramuscular hydatid cyst are rare even in endemic countries. It is challengig to distinguish subcutaneous and intramuscular hydatid cysts from soft tissue tumors. This study aimed to present the clinical features of primary soft tissue hydatid cyst cases without liver and lung hydatid cyst in the Southeast Anatolian region, where hydatid cyst disease is endemic.

METHODS

Patients admitted to the Şanlıurfa Training and Research Hospital General Surgery and Orthopedics and Traumatology Outpatient Clinic between September 2018 and December 2019 with complaints of pain and/or swelling under the skin and soft tissue were evaluated. After the examinations, the records of the patients who were operated on with a pre-diagnosis of hydatid cyst and whose histopathologic evaluation was reported as a hydatid cyst were reviewed retrospectively.

RESULTS

Eight patients were included in the study. The mean age of the patients was 39.75±14.80 years. Lesions were located in neck (12.5%), left thoracic posterior area (25%), gluteus (25%), thigh (12.5%), right upper quadrant of abdominal wall (12.5%), and under the right clavicle (12.5%). When imaging methods were examined, ultrasonography was performed in 7 patients (87.5%), chest computed tomography was performed in 1 patient (12.5%), and magnetic resonance imaging was performed in 2 patients (25%).

CONCLUSION

Diagnosis of hydatid cyst should be considered in the differential diagnosis of soft tissue tumors in countries of endemic regions for hydatid cyst disease such as Southeastern Anatolia Region, Turkey.

Primary hydatid cyst in the posterior thigh, and its percutaneous treatment

Hydatid cyst (echinococcosis) is an endemic parasitic disease, usually encountered in those dealing with agriculture and livestock. The most frequently affected organs are the liver and the lungs. The disease is very rarely encountered in soft tissues. Diagnosing a soft-tissue hydatid cyst may be challenging unless the mass possesses the characteristic features of a hydatid cyst. Soft-tissue hydatid cysts may be treated percutaneously, just like those encountered in the liver. In this case report, we present the radiological findings and modified percutaneous aspiration-injection-reaspiration (PAIR) treatment of a hydatid cyst located in the posterior aspect of the thigh.

Adductor magnus muscle primary hydatid cyst rare unusual site: A case report

INTRODUCTION

The preferred localization of human echinococcosis is the liver and lungs, which account for 85% of cases. Primary musculoskeletal hydatidosis are seldom reported in literature and their incidence is unknown. Primary solitary intramuscular hydatid disease is rare, even in countries in which echinococcosis is endemic and accounts for 1% of all human echinococcosis sites.

CASE PRESENTATION

37-year-old male farmer presented with primary hydatid cyst of the upper medial side of right thigh (Inside adductor magnus muscle) who was managed successfully by preoperative and postoperative dual treatment of albendazole together with surgery.

DISCUSSION

This site of localization has not been reported previously. It is essential to establish definitive preoperative diagnosis of skeletal muscle hydatid cysts. This contraindicates certain treatment options like marginal excision or incisional biopsy due to the likelihood of dissemination and anaphylactic shock on spillage. Pericystectomy remains treatment of choice in musculoskeletal hydatid cysts.

CONCLUSION

Hydatid disease should be included in the differential diagnosis of muscular masses, regardless of its location, especially in endemic areas.

Musculoskeletal Echinococcus infection as a rare first presentation of hydatid disease: case report

Background

Hydatid disease (HD) is a cosmopolitan parasitosis caused by Echinococcus granulosus that can potentially affect any part of the human body. Liver and lungs are the most frequent localizations. Primary musculoskeletal hydatidosis are seldom reported in literature and their incidence is unknown.

Case presentation

We deem interesting to report a case of a primary hydatid cyst in a 25-year-old patient who presented with a painful swelling of the right elbow. Meticulous examination and preoperative imaging did not reveal other localizations. Patient was admitted for surgery where total excision of cyst was done without intraoperative spillage and a cutaneous skin flap was subsequently required to make up for soft tissue loss.

Conclusion

Primary hydatid cysts are sometimes difficult to diagnose preoperatively. It should be considered in the differential diagnosis of subcutaneous cystic lesions in regions where hydatid cysts are endemic. Currently, surgical excision is deemed first choice treatment for solitary cysts and antihelminthic treatment should be initiated preoperatively in the case of risk of rupture or in the event of complications.

Uncommon localizations of hydatid cyst. Review of the literature

INTRODUCTION

Hydatid disease is an endemic anthropozoonosis with usual localization in liver and lungs. Rarely it localizes in uncommon sites as spleen, skeleton, kidney, brain, cardiac muscle, peritoneum, sub cutis. Complications of uncommon localizations are the same that for usual ones.

MATERIAL AND METHODS

Review of the literature on rare and atypical localization of hydatid cysts in soft tissues. Key-words used on Pub-Med [(echinococ OR hydatid) AND (soft tissue OR subcutaneous OR cutaneous)] without time limit. There were found 282 articles; 242 were excluded because of muscular or bone localizations. 40 were coherent.

RESULTS

Different variables are taken into account: age, sex, geographic area, anatomic localization of the cyst, dimension, symptoms, signs, mobility, blood exams and specific serological tests, imaging techniques for diagnosis, existing of septa in the structure, treatment, anaesthesia, spillage, neo-adjuvant and adjuvant treatment, follow-up period, recurrent lesions.

CONCLUSION

It would be useful create an homogeneous and standardized collection of data of these rare and potentially life-threatening conditions in order to create guide-line of diagnostic and therapeutic process and create (or adopt) unique classification of the lesions.