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Musculoskeletal Hydatid Cysts Resembling Tumors: A Report of Five Cases
Authors:Güray Toğral MD  Şefik M Arıkan MD  Timur Ekiz MD  Ahmet F Kekeç MD  Mehmet F Ekşioğlu MD
Affiliation:1. Department of Orthopaedics and Traumatology, Oncology Training and Research Hospital, Ankara, Turkey;2. Department of Physical and Rehabilitation Medicine, Ankara Physical Medicine and Rehabilitation Training and Research Hospital, Ankara, Turkey
Abstract:Although challenges in treatment of musculoskeletal hydatid cysts (HC) lesions have been documented, data regarding the musculoskeletal HC lesions resembling tumor is scarce. This paper presented 5 patients (3 males, 2 females) with a mean age of 41.6 years with tumor‐like lesions of HC. Three of them had left ilium and acetabulum involvement, one involved left femur, and one involved left thigh muscle compartments. Pain was the main symptom and was seen in all patients. Clinical examination, radiologic evaluation, and histologic analysis were performed for diagnosis. Patients were treated through different surgical options, including simple debridement, bone cement filling with or without internal fixation, hip arthrodesis, reconstruction using hemipelvic replantation with femoral prosthesis and distal femur endoprosthetic replacement. After surgery, the operation region was washed by 20% hypertonic saline, and debridement was performed carefully without contamination. All patients received albendazole treatment. Cases were followed up 1 to 9 years for the recurrence. Walking difficulty and pain were the main symptoms during the follow‐up. One patient was symptom‐free. A reoccurrence in the perioperative soft tissue was detected in only one patient and control visits with antihelmintic treatment were recommended. We would like to emphasize that HC should be kept in mind for the differential diagnosis of the cystic or tumoral lesions of the musculoskeletal system, particularly in the endemic regions. Prompt diagnosis is of paramount importance for preventing destruction and complications.
Keywords:Hydatic cyst  Echinococcosis granulosus  Iliac wing  Muscle hydatidosis
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