Primary giant hydatid cysts of the thigh and the gluteal region: a case report.

Primary musculoskeletal echinococcosis is rare and accounts for 2-3% of the patients with hydatid disease. We report a case of giant primary hydatid cysts of the thigh and the gluteal region in an 82-year-old female, who presented with a painful multiple palpable mass. The diagnosis was confirmed by imaging and serology. Total resection was performed through an extended lateral approach of the thigh and intraoperative findings revealed infected giant hydatid cysts. The postoperative outcome was uneventful. Albendazole drug (400mg per day) was given for the next 3 months. At 6 months follow-up, the patient was satisfied with no complications or recurrence.

Sparganosis: an under-recognised zoonosis in Australia?

Sparganosis is a rare zoonotic parasitosis that is sporadically reported worldwide. In Australia, the causative tapeworms are considered endemic in wildlife animals, however, there have been only five reported human infections. We present three additional cases of sparganosis, involving two Australian born gentlemen who have never travelled overseas and a woman who emigrated from Ethiopia. The first man presented with two unusual subcutaneous lumps that migrated along the anterior abdominal wall connected by a tunnel. The second man presented with two separate lumps, one on the thigh and the other on the left upper abdomen over a 4-week interval. The woman presented with 6 weeks of intermittent fevers, night sweats, abdominal pain and passing intestinal worms. This series of patients suggests that sparganosis is under-recognised in Australia and serves as a reminder for clinicians to the varied presentations that can be characteristic of this lesser known zoonosis.

Cystic echinococcosis in the thigh: a case report.

Intramuscular cystic echinococcosis is a very rare occurrence. Herein we report a case of a 37-year-old patient who presented with progressive swelling of his left thigh. Ultrasound evaluation showed a multicystic, encapsulated lesion (16 × 3.5 × 8.5 cm) in the M. vastus lateralis, and serology confirmed the diagnosis of Echinococcus granulosus s.l. infection. No additional cysts were detected upon total body CT scan. The patient was treated with albendazole pre-operatively; surgical resection of the mass was then successfully performed. The patient feels well and no signs of residual infestation were seen after 2 years of follow-up.

[Primary musculo-skeletal echinococcosis of chronic evolution]. / Equinococosis quística músculo-esquelética primaria de evolución crónica.

Cystic echinococcosis is a chronic parasitic zoonosis of high prevalence in Chile. We report a clinical case of a 66-year-old man, domiciled in an urban area of the Maule Region, who presents skeletal muscle cystic echinococcosis. Consultation for pain, volume increase and left thigh fistula that gives out crystalline fluid. In the study with imaging techniques, multiple cystic lesions are identified in the sacral wing, iliac bone, soft tissues of the groin and left thigh. No cysts were evident in other organs. Serology Elisa IgG was positive Echinococcus granulosus. Surgical resection of soft tissue injuries. Combined antiparasitic therapy with albendazole and praziquantel was started, with good clinical response. Upon discontinuation of antiparasitic therapy at the initiative of the patient, symptoms are reinitiated.

Equinococosis quística músculo-esquelética primaria de evolución crónica / Primary musculo-skeletal echinococcosis of chronic evolution

Resumen La equinococosis quística es una zoonosis parasitaria crónica de alta prevalencia en Chile. Se presenta el caso clínico de un varón de 66 años, proveniente de la Región del Maule, con una equinococosis quística músculo-esquelética. Consultó por dolor, aumento de volumen y una fístula en muslo izquierdo, con salida de líquido cristalino. En el estudio imagenológico se identificaron múltiples lesiones quísticas en el ala sacra, hueso ilíaco y tejidos blandos de zona inguinal y muslo izquierdo. La serología Elisa IgG para Equinococcus granulosus fue positiva. Se realizó la resección quirúrgica de las lesiones musculares y se inició terapia antiparasitaria combinada con albendazol y praziquantel, con buena respuesta clínica; sin embargo, al suspender la terapia, por iniciativa del paciente, se reiniciaron los síntomas.

Cystic echinococcosis is a chronic parasitic zoonosis of high prevalence in Chile. We report a clinical case of a 66-year-old man, domiciled in an urban area of the Maule Region, who presents skeletal muscle cystic echinococcosis. Consultation for pain, volume increase and left thigh fistula that gives out crystalline fluid. In the study with imaging techniques, multiple cystic lesions are identified in the sacral wing, iliac bone, soft tissues of the groin and left thigh. No cysts were evident in other organs. Serology Elisa IgG was positive Echinococcus granulosus. Surgical resection of soft tissue injuries. Combined antiparasitic therapy with albendazole and praziquantel was started, with good clinical response. Upon discontinuation of antiparasitic therapy at the initiative of the patient, symptoms are reinitiated.

Diagnosis of primary hydatid cyst of thigh by fine needle aspiration cytology.

Hydatidosis is a parasitic infestation caused by larval form of the tapeworm, Echinococcus granulosus. Primary hydatid cyst in the skeletal muscles and subcutaneous tissue of thigh without involving thoracic and abdominal organs is an exceptional entity, even in countries where the Echinococcus infestation is endemic. We report an unusual case of primary hydatid cyst of thigh in proximity to skeletal muscles. This case illustrates that echinococcal disease should be considered in the differential diagnosis of every subcutaneous cystic mass. This case is presented here for its rarity.

Unusual sites for primary hydatid cysts: self experience with five cases.

Hydatid disease is a zoonotic disease caused by the tapeworm Echinococcus granulosus. It is common in the sheep-raising countries including Iraq. The usual site for involvement is the liver, followed by the lungs. Other sites may be affected less commonly and require a high index of suspicion for diagnosis. We present our experience with five cases of unusual sites of primary hydatid cyst, including the pancreas, the abdominal wall, the spleen, the back and the thigh. Three patients were females and two patients were males; their ages were between 15 and 39 years. All the patients were operated at our centre, and after a period of follow-up ranging between 2 and 6 years, there was no reported recurrence in any of the patients, neither at the primary site nor at other sites.

Hydatid cyst of thigh diagnosed on ultrasonography - a rare case report.

Hydatid disease is a parasitic disease that is endemic in many parts of the world, especially in South America, the Middle East, Africa, Australia, and the Mediterranean region, including Turkey. This article presents an unusual case of subcutaneous hydatid cyst in the right medial side of the thigh. According to our world literature search, few cases are reported. This site of localization is very rarely diagnosed on ultrasonography.

Primary subcutaneous hydatid cysts: a review of 22 cases.

AIM: We aimed to review cases of primary subcutaneous hydatid cysts whether this is a fearsome disease or a benign progressed pathology. These cysts are rare, have difficulty in diagnosis and management, particularly for inexperienced clinicians. METHODS: We searched key words of "echinococcosis, hydatid, soft tissue, subcutaneous, cutaneous" at MEDLINE/PUBMED. We eliminated unrelated articles, cases with primary visceral hydatid focus or muscular cysts. Twenty publications including 22 patients were suitable for analysis. We contacted with authors of the articles for missing data. Follow-up periods and recurrences were updated. RESULTS: All patients were from endemic areas and most from rural regions (90%). Most frequent locations were thigh (27%) and gluteal region (9%). Mean size was 5.7 + 3.1 cm (2-15 cm). Main symptom (70%) was painless, slow growing mass with normal overlying skin. Serologic tests were usually negative (79%). Only 45% of the patients were diagnosed as hydatid cyst before treatment. Most cases (91%) were treated by surgical excision and spillage occurred at 25% of them. Cyst pouchs were irrigated with protoscolocidal solutions after cyst removal. There was no anaphylaxis during procedures. There was no recurrence with a mean follow-up of 26 + 18 months (6-60 months). CONCLUSION: Primary subcutaneous hydatid cyst should be in mind for differential diagnosis of soft tissue masses particularly for patients who lived in regions where hydatid cyst is endemic. There is no reported anaphylaxis or recurrence during diagnostic or therapeutic interventions. Complete excision is the best treatment option. Primary subcutaneous hydatid cysts generally look like a benign progressed disease.

Mammary and femoral hydatid cysts.

Hydatid cyst disease most commonly affects liver and lungs, but it can affect all viscera and soft tissues of the body. Simultaneous mammary and femoral hydatid cysts, without any other visceral involvement, are extremely rare. This is a case report of 25-years-old female, presenting with lump in left breast mimicking fibroadenoma and lump in right thigh mimicking fibroma. Both turned out to be hydatid cysts.

Primary hydatid cyst with an unusual location--a case report.

Human cystic echinococcosis, a zoonotic infection caused by Echinococcus granulosus, is still a largely extended public health problem in endemic regions (China, Middle East, Mediterranean region, South America, Russian Federation, etc.). Primary echinococcosis may develop in almost any organ (liver, lung, kidney, spleen, mediastinum, heart, brain, bones, pancreas, breast, ovaries, etc.). The liver and the lungs are the most frequently involved organs. Primary hydatid disease of the soft tissue is extremely rare, even in endemic areas. The paper will be focused on analyzing this rare disease. A 46-years old woman who came to our Department of Surgery with a 7/8 cm painless, round, palpable mass in the subcutaneous tissue of the proximal anteromedial side of the right thigh. Based on clinical and laboratory findings and imaging techniques we suspected a hydatid cyst. Conservative surgery associated with antihelminthic substances intraoperative and Albendazole postoperative was performed. After an uneventful recovery the patient was discharged 7 days after operation. No local or systemic recurrences were detected during 1 year follow up.

[Rare forms of hydatid cyst. Case reports]. / Localizari rare ale chistului hidatic. Prezentari de caz.

With a frequency still high in surgical pathology at the 2nd Surgical Clinic of the Clinical Emergency Hospital in Constanta, hydatid disease has, besides the usual hepatic and lung locations, other uncommon variants. This study presents two clinical cases with rare locations of the disease, the thigh and scapulo-humeral joint. The intraoperative images and the comments emphasize the characteristic features of these cases.

Primary hydatid disease of the thigh. A rare location.

Primary muscle hydatidosis is very rare, accounting for less than 1% of hydatid cyst locations. Clinical symptoms are insidious and non-specific causing a frequent delay in diagnosis. Intramuscular hydatid disease can cause a variety of diagnostic problems, especially in the absence of typical radiologic findings. We report the observation of an 82-year-old man consulting for inguinal tumefaction with radiological exploration suggestive of hydatid cyst of the adductors muscles. Magnetic resonance imaging (MRI) is helpful in diagnosis, since it reveals a very suggestive aspect and demonstrates the relationship between cysts and adjacent structures. Treatment of muscle echinococcosis is based on surgery, which is curative and incurs a low risk of local relapse.

Solitary hydatid cyst of the thigh: a challenging diagnosis.

A 53-year-old woman presented with an enlarging mass in the medial aspect of her right thigh. Magnetic resonance imaging suggested an intramuscular hydatid cyst. The cyst was surgically excised. Although muscular hydatidinosis is rare, its resemblance to soft tissue tumors warrants careful diagnosis since any invasive diagnostic measures may lead to fatal complications.