Primary hydatid cyst of the root of the thigh: a case report and review of the literature

Hydatid disease of bone is a rare event, and it is characterized by a high diagnostic and therapeutic complexity. We report a case of primary hydatidosis of the proximal thigh involving both the soft tissues and the proximal femur in a 59-year-old man. It has been possible to establish the diagnosis only 8 years after the appearance of the first symptoms (painful swelling over the root of the left thigh), when the patient came to our institution after several investigations.     

Primary hydatid cyst of the scaphoid: case report

Hydatid cyst caused by Echinococcus granulosus is a parasitic disease that can affect different organs. It is difficult to diagnose and has a tendency to recur. Primary bone involvement occurs in 0.5% to 4.0% of all patients with hydatid cysts. We present a 31-year-old woman with a primary hydatid cyst in the left scaphoid. Despite the availability of advanced imaging and laboratory investigation modalities (such as magnetic resonance imaging and serological studies) to make an adequate differential diagnosis of a cystic lesion in our case, intraoperative clinical suspicion led to the diagnosis. This was followed by a successful outcome without recurrence after 12 months.     

Hydatid cyst of the pancreas:Report of an undiagnosed case of pancreatic hydatid cyst and brief literature review

AIM: To overview the literature on pancreatic hydatid cyst(PHC) disease, a disease frequently misdiagnosed during preoperative radiologic investigation.METHODS: PubMed, Medline, Google Scholar, and Google databases were searched to identify articles related to PHC using the following keywords: hydatid cyst, hydatid disease, unusual location of hydatid cyst, hydatid cyst and pancreas, pancreatic hydatid cyst, and pancreatic echinococcosis. The search included let-ters to the editor, case reports, review articles, original articles, meeting presentations and abstracts that had been published between January 2010 and April 2014 without any restrictions on language, journal, or country. All articles identified and retrieved which contained adequate information on the study population(including patient age and sex) and disease and treatment related data(such as cyst size, cyst location, and clinical man-agement) were included in the study; articles with in-sufficient demographic and clinical data were excluded. In addition, we evaluated a case of a 48-year-old fe-male patient with PHC who was treated in our clinic.RESULTS: A total of 58 patients, including our one new case,(age range: 4 to 70 years, mean ± SD: 31.4 ± 15.9 years) were included in the analysis. Twenty-nine of the patients were female, and 29 were male. The information about cyst location was available from studies involving 54 patients and indicated the follow-ing distribution of locations: pancreatic head(n = 21), pancreatic tail(n = 18), pancreatic body and tail(n = 8), pancreatic body(n = 5), pancreatic head and body(n = 1), and pancreatic neck(n = 1). Extra-pancreatic locations of hydatid cysts were reported in the studies involving 44 of the patients. Among these, no other focus than pancreas was detected in 32 of the patients(isolated cases) while 12 of the patients had hydatid cysts in extra-pancreatic sites(liver: n = 6, liver + spleen + peritoneum: n = 2, kidney: n = 1, liver + kidney: n = 1, kidney + peritoneum: n = 1 and liver + lung: n = 1). Serological information was available in the studies involving 40 patients, and 21 of those pa-tients were serologically positive and 15 were serologi-cally negative; the remaining 4 patients underwent no serological testing. Information about pancreatic cyst size was available in the studies involving 42 patients; the smallest cyst diameter reported was 26 mm and the largest cyst diameter reported was 180 mm(mean ± SD: 71.3 ± 36.1 mm). Complications were avail-able in the studies of 16 patients and showed the fol-lowing distribution: cystobiliary fistula(n = 4), cysto-pancreatic fistula(n = 4), pancreatitis(n = 6), and portal hypertension(n = 2). Postoperative follow-up data were available in the studies involving 48 patients and postoperative recurrence data in the studies of 51 patients; no cases of recurrence occurred in any patient for an average follow-up duration of 22.5 ± 23.1(range: 2-120) mo. Only two cases were reported as having died on fourth(our new case) and fifteenth days respectively. CONCLUSION: PHC is a parasitic infestation that is rare but can cause serious pancreato-biliary complica-tions. Its preoperative diagnosis is challenging, as its radiologic findings are often mistaken for other cystic lesions of the pancreas.     

Ovarian hydatid cyst: A case report

Discovering an hydatid cyst in pelvic region, especially as primary localization, is a rare event; as a matter of fact according to data provided by literature the incidence is between 0.2 and 2.25%. The ovarian involvement is often secondary to a cyst's dissemination localized in a different site. When possible the optimal treatment is represented by radical laparotomic cystectomy. We report a case of an old woman affected by this pathology that we have treated with a cyst's marsupialization after a draining and irrigation of cyst cavity with hypertonic saline solutions.     

Primary hydatid cyst of the rib mimicking chest wall tumor: a case report

Hydatidosis, caused by Echinococcus granulosus, is still an endemic parasitic disease in the Mediterranean area, South America, North Africa, and Australia. The most common anatomic location of hydatid disease is the liver, followed by the lung. Hydatidosis is located in the bones in 0.5% to 2% of all cases. A hydatid cyst can be seen in any part of the body. However, primary hydatid cyst of the rib in childhood is exceedingly rare. We report the first case of a pediatric hydatid cyst of the rib mimicking chest wall tumor.     

Primary spinal extradural hydatid cyst in a child: case report and review of the literature

Spinal hydatid cyst is a rare but serious condition. An 8-year-old boy presented with back pain, progressive weakness and numbness in both legs. Magnetic resonance imaging (MRI) of the lumbar region showed a cystic lesion with regular contour located in extradural space. There was cerebrospinal fluid- (CSF-) like signal intensity on T1- and T2-weighted images. The lesion had excessively compressed the dural sac and caudal roots, and expanded to the L3 and L4 neural foramina. The case was explored with L2, L3, L4 laminectomy and the hydatid cyst was removed totally. The clinical presentation, diagnosis and surgical treatment of this rare case of spinal hydatid disease is discussed, and all available cases of primary extradural hydatid cyst reported in the literature are presented.     

Laparoscopic cystectomy for splenic hydatid cyst: a case report

Even in countries where it is considered endemic, splenic hydatid cyst is a very rare disease in childhood. Partial or total splenectomy has generally been the treatment of choice for this condition. This is the first report of laparoscopic cystectomy as treatment of isolated splenic hydatid cyst in childhood. A 10-year-old girl with isolated splenic hydatid cyst was successfully treated by laparoscopic cystectomy and splenic preservation. The authors have demonstrated that laparoscopic cystectomy for an isolated splenic hydatid cyst is technically feasible, safe, and is associated with a shorter hospital stay and good cosmetic appearance.     

Primary mediastinal hydatid cyst causing a paralysis of the recurrent nerve

Hydatid cyst disease stills a health problem in Morocco. We describe a rare case of a mediastinal hydatid disease that developed in the left thoracic cavity, and associated with paralysis of the left recurrent laryngeal nerve. Paralysis of thoracic nerve (phrenic nerve, sympathetic …) to the best of our knowledge, there is only one case report of paralysis of the left recurrent laryngeal nerve secondary to compressive effects from mediastinal hydatid cysts.     

Traumatic renal hydatid cyst rupture: report of a case

In this case report we present a 30-year-old male patient, who had renal hydatid cyst rupture due to blunt abdominal trauma. The case is presented and the relevant literature is reviewed and discussed. Despite its rarity, traumatic renal hydatid cyst rupture should be kept in mind in the differential diagnosis of a blunt abdominal trauma in the endemic area.     

Primary echinococcal cyst of the thyroid: Report of a case

A case of primary hydatid disease of the thyroid, a rare location, is presented. The patient was a 50-year-old woman who presented with a neck mass at the thyroid region, which was noticed 2 months before her presentation. Although the clinical impression was of a neoplastic lesion (adenoma or carcinoma), a hydatid cyst was considered intraoperatively and confirmed by a frozen section histology. It was completely removed. No other sites of hydatid disease were found and the patient remained well postoperatively. In patients with a solitary cyst in the thyroid, the possibility of hydatid disease, though rare, should be always kept in mind, because a needle aspiration biopsy is a potentially harmful procedure.     

Laparoscopic treatment of hydatid cyst of the liver: a case report.

Laparoscopic surgery may be used for treating a variety of benign hepatic lesions in select patients. The anatomic location of the lesions are more important than any other peculiarity when laparoscopic management is used. The aim of this report is to discuss the effects and feasibility of laparoscopic treatment of hydatid cyst of liver. The procedure is feasible and safe, offering all the advantages of laparoscopic surgery.     

Primary hydatid cyst of the breast: A case report

We describe herein the rare case of a hydatid cyst found in the breast of a 26-year-old woman. Clinically, the mass was at first suspected of being a fibroadenoma, but fine needle aspiration cytology (FNAC) yielded clear fluid only. Histopathologic examination of the resected speciman confirmed that it was a hydatid cyst.     

An arcane case report of primary intramuscular hydatid cyst of thigh

IntroductionHydatid diseases are a cystic parasitic infestation caused by Echinococci which are endemic to parts of India and commonly occur in agricultural workers. Primary intramuscular hydatidosis is a rare manifestation of hydatid disease.Presentation of caseOur case report describes a rare case of primary intramuscular hydatidosis in an agricultural worker with no involvement of any other viscera. This was diagnosed with clinical evaluation, radiological modalities and managed surgically.DiscussionHydatid disease is endemic in parts of India. Primary intramuscular hydatidosis is uncommon because the lactic acid in the muscle and muscle contractility hinders the development of cysts making it improbable diagnosis on first presentation. Hydatid cyst demonstrates a wide variety of imaging features, which can vary according to growth stage, associated complications and affected tissue. The treatment of choice is complete surgical excision of the cyst along with thorough irrigation of the surrounding soft tissues combined with the use of systemic antiparasitic drugs after surgery.ConclusionIn a patient of an agricultural background of cattle rearing living in an endemic region and presenting with a swelling in the musculoskeletal system, a suspicion of hydatidosis should always be kept in the clinicians mind, so that it can be diagnosed using a multimodal approach and managed properly in a timely manner.     

Solitary hydatid cyst in the pelvis: A case report

Hydatid disease mainly affects the liver and the lungs. Pelvic involvement have been rarely reported in the literature. Herein we present a rare case of isolated hydatid cyst of pelvis attached to the urinary bladder.     

Primary hydatid cyst of the retroperitoneum

Retroperitoneal contamination may occur during the natural history of hydatid disease. Primary hydatid cyst of the retroperitoneum is extremely rare. The authors report a case of a giant retroperitoneal hydatid cyst. Clinicians and surgeons must be aware of this possibility and follow a policy of nonsystematic puncture of an abdominal cyst and avoid spillage during surgery. Symptoms are related to the size, location, or ensuing complications of a cyst. Its occurrence should be strongly suspected ahead of any abdominal cyst, especially in an endemic area, where it may act as a parasite. Total and careful surgical excision is the gold-standard therapy.     

Primary hydatid cyst of pancreas: Case report and review of literature

IntroductionHydatid disease is caused by the larval stage of Echinococcus granulosus. It most commonly affects the liver and lung. Pancreatic hydatid cyst (PHC) is very rare with incidence of 0.14%–2%.Presentation of caseA 40 year old lady presented with epigastric pain for last 3 months. A 5 × 5 cm abdominal lump occupying the epigastric and left hypochondrial region was noted on physical examination. Ultrasonography (USG) and Contrast enhanced Computed Tomogrpahy (CT) revealed a 55 × 57 mm cystic structure in the pancreatic body. Endoscopic ultrasound guided fluid aspiration cytology revealed normal Carcinoembryonic antigen and Amylase levels. Cytological examination was noncontributory. During open surgical exploration, it was found to be a hydatid cyst. After irrigation with scolicidal agent and evacuation of cystic contents, Partial cystectomy with external drainage was done. Histopathological biopsy revealed Hydatid cyst. Post-operative ELISA (Enzyme linked immunosorbent assay) for Echinococcal antigen was positive.DiscussionPHC is a rare entity. Most common mode of spread is hematogenous. Cysts in pancreatic head can present as obstructive jaundice. Cysts in body and tail are usually asymptomatic. USG, CT and Hydaitd serology can help in diagnosis and monitoring recurrence. Surgical exploration is treatment of choice. Options include pericystectomy, partial cystectomy +/− external drainage/omentopexy, marsupialization or cysto-enterostomy. Preoperative and Post-operative anti helminthic (Albendazole) is recommended.ConclusionPHC can masquerade as pseudocyst or cystic neoplasm of pancreas. It should always be considered in the differential diagnosis of cystic pancreatic lesion in patients from endemic regions.     

Primary adrenal hydatid cyst: a case report

A rare case of primary adrenal hydatid cyst is reported in a 56-year-old male. The cyst was discovered incidentally. The only symptom was hypertension. Partial excision of the gland and pericystectomy were performed. Surgical treatment was also therapeutic for the hypertension.     

Intermuscular hydatid cyst in a 4-year-old child: a case report

Human Echinococcus infection still remains an important health problem in endemic regions. Primary musculoskeletal Echinococcus infection is very rare without involving the thoracic and abdominal organs. There has been no reported case of intermuscular hydatid cyst in the very early ages of childhood. Here we report a case of a 4-year-old girl with a primary intermuscular hydatid cyst in the left thigh. It was localized between the adductor muscles and iliopsoas muscle. It was removed without destroying the cyst wall and there were no complications. Hydatid cyst should be considered especially in the endemic areas when evaluating cystic masses. Hydatid cyst can be treated by operation.     

Recurrent solitary hydatid cyst of the subcutaneous tissue

A 28-year-old male patient presented with a recurrent swelling in the left lateral chest wall just below the left axilla since seven years. Patient was operated for the same swelling eight years back and its biopsy report showed hydatid cyst. Patient had not taken any antihelminthic post operatively. Based on this, diagnosis of recurrent subcutaneous hydatid cyst was made and total cystectomy was done. Post operatively patient was started on albendazole. On follow up of one year there is no recurrence. Hydatid cyst is caused by the larval stage of Echinococcus. Four species of the Echinococcus tapeworm can produce infection in humans. E. granulosus and E. multilocularis are the most common, causing cystic and alveolar echinococcosis respectively, while E. vogeli and E. oligarthrus have rarely been associated with human infection. Hydatid cyst of the subcutaneous is extremely rare. This case report highlights the rare location of the hydatid cyst as well its recurrence in rare location.     

Primary hydatid cyst of the neck: a case report

Hydatid cysts in the neck are quite rare, even in areas where the disease is endemic. The role of radiological investigation is important and, in these cases, the involvement of other organs should be investigated. The cyst should be excised as a whole, without being ruptured, to prevent any treatment complications. This paper presents a case of an isolated hydatid cyst localised in the supraclavicular region without any pulmonary or hepatic involvement.