CT findings of hydatid cyst with unusual location: infratemporal fossa

Hydatid Cyst of the Oromaxillofacial Region - A Rare Location: A Case Report and Review of the Literature

Oromaxillofacial hydatid cysts are rare, even in countries where echinococcosis is endemic. This study aimed to describe an isolated oromaxillofacial hydatid cyst and to discuss the epidemiology, clinical features, and treatment thereof. The authors report the case of a 12 year-old boy who presented with a 2-week history of an enlarging hydatid cyst in the parapharyngeal space extending to the neck, with no pulmonary or hepatic involvement. We present our clinical findings, diagnostic techniques, and treatment and review the relevant literature. Forty-one cases, with a male:female ratio of 1.21:1, have been reported, mostly in patients aged 20 to 40 years (both sexes). Oromaxillofacial hydatid cysts are most commonly located in the parotid gland (19.51%, n = 8), submandibular region including the submandibular gland (17.07%, n = 7), and infratemporal fossa (14.63%, n = 6). Only 2 (4.88%) cases of hydatid cysts in the parapharyngeal space have been reported before. Although isolated parapharyngeal space hydatid cysts are rare, oromaxillofacial surgeons should consider relevant diagnostic and therapeutic procedures to ensure complete resection.

Hydatidosis of infratemporal fossa with proptosis - an unusual presentation: a case report and review of the literature

BACKGROUND

Hydatid disease is one of the common zoonotic diseases caused by the larval stage of Echinococcus granulosus. It is endemic in sheep-raising and cattle-raising areas worldwide and humans are an accidental intermediate host following the ingestion of the larvae. Head and neck involvement of echinococcosis is a rare entity and involvement of the infratemporal region is extremely rare even in endemic areas. Only a few cases of hydatid cysts located in the infratemporal fossa have been reported in the literature. Moreover, extension of the hydatid cyst into the intraorbital region and infiltrating into the surrounding orbital bone is even rarer.

CASE PRESENTATION

We present a case of a 65-year-old Gurung Nepalese woman with painless proptosis of her left eyeball of 2 months' duration with recent progressive diminution of vision for 15 days. Radiological findings showed a cystic mass in the left infratemporal fossa extending into the left orbit and involving the surrounding orbital bone. Surgical removal was carried out. On histopathological evaluation, it was reported as hydatid cyst infiltrating into the bone. She was prescribed albendazole and discharged after surgery. However, she was lost to follow up and returned after 15 months with recurrence and proptosis of the same eye. Repeat excision of the lesion was carried out and postoperatively she was administered tablet albendazole. She was found to be disease free after 6 months of follow up.

CONCLUSIONS

Clinical and radiological findings are important but may not be sufficient in the preoperative diagnosis of hydatid disease especially if rare sites are involved. Proptosis may be seen in several conditions and orbital or infratemporal hydatidosis, although rare, should be considered a differential diagnosis.

Skull base hydatid cyst with intracranial extension presenting as vocal cord palsy: a case report

Hydatid disease of the skull base is extremely rare, and intracranial extension of hydatid cysts through the skull base is even rarer. We report an interesting case of a 42-year-old man who presented with features of right vocal cord palsy. The diagnosis of hydatid cyst was made based on his history and on pre-operative MRI and was confirmed by surgery and histopathological examination.

Two different presentations of orbital echinococcosis: a report of two cases and review of the literature

PURPOSE

To report two patients with different presentations of orbital echinococcosis, namely hydatid and alveolar cysts and to compare their clinical, imaging and histopathologic findings and treatment.

METHODS

This retrospective study includes two young rural children who were referred because of progressive proptosis.

RESULTS

Orbital imaging in both cases revealed cystic intraorbital lesions. With a clinical suspicion of hydatid and alveolar cysts, both patients underwent intact surgical excision. Histopathologic evaluation confirmed the diagnoses.

CONCLUSIONS

Clinical findings and imaging can help in the preoperative diagnosis of patients with orbital echinococcosis. Knowledge of the nature of cystic orbital lesions is important in preventing complications. Alveolar cysts are more invasive than hydatid cysts and their treatment is more complicated.

Hydatid disease of the skull base: report of three cases and a literature review

We report three cases of hydatid disease of the skull base and the treatment thereof. The first involved the anterior cranial fossa and paranasal sinuses. The second was located in the infratemporal fossa. The last involved the temporal bone and posterior cranial fossa. Hydatid disease is endemic in many parts of the world where livestock farming is practiced and is highly endemic in sub-Saharan Africa. Although hydatid disease of the head and neck is rare, it should be considered in the differential diagnosis of cystic disease in the head and neck region. Of the three forms of hydatid disease, Echinococcus granulosis is most common and gives rise to cystic hydatid disease. Most hydatid cysts are "silent," but become clinically apparent because of their mass effects, when they rupture, or if they become superinfected. Computed tomography scanning and magnetic resonance imaging are the best diagnostic tools. Hydatid disease can be successfully treated by a combination of surgery and chemotherapy.

Cutaneous cysts of the head and neck

PURPOSE

A retrospective study on the features of cutaneous cysts of the head and neck as seen in a North Jordanian population.

PATIENTS AND METHODS

The records of the Department of Pathology at Jordan University of Science and Technology were reviewed for patients with cutaneous cysts of the head and neck during the 12-year period extending between 1991 and 2002. Applicable records were retrieved, reviewed, and analyzed. Primary analysis outcome measures included patient age, gender, location of the cyst, type, clinical presentation, and treatment. The records of 488 patients were available for analysis.

RESULTS

Epidermoid cyst was the most frequent lesion (49%) followed by pilar cysts (27%), and dermoid cysts (22%). The site affected most frequently was the scalp (34%), predominantly with pilar cysts (96%). Epidermoid cyst was the most frequent lesion in the neck (68%), cheeks (77%), periauricular area (70%), and the nasal area (55%). Dermoid cyst was the most frequent lesion in the periorbital area (52%). Females represented 51% of the patients and males accounted for 49%. The peak of age distribution for patients with dermoid cysts was at the first decade, and both of epidermoid and pilar cysts peaked at the third decade. Infection presented in 2.5% of cases. All cysts were enucleated surgically.

CONCLUSION

Maxillofacial surgeons often encounter cutaneous cysts of the head and neck, and they must be familiar with the clinicopathologic characteristics of these lesions.

Multiple hydatid cysts of the neck, the nasopharynx and the skull base revealing cervical vertebral hydatid disease

Hydatid disease is caused by the parasitic tapeworm Echinococcus. This parasite in larval stage can thrive in many parts of the body, most commonly in the liver and the lung. Hydatid disease in the head and neck is uncommon and hydatid cyst presents rarely as a cervical mass. Cervical vertebral echinococcosis is rare. We report a 14-year-old girl with multiple cervical spine hydatid cysts of the C1-C2 vertebrae that spread into the surrounding paravertebral tissues and involve the nasopharynx and the skull base particularly the left jugular foramen. This process has caused a progressive swelling in the left side of the neck located in the retrostyloid compartment of the parapharyngeal space with paralysis of cranial nerves (VI, IX, X, XI, XII). The diagnosis was made based on the image obtained from CT and MRI examinations. Characteristics of this rare disease, diagnosis and treatment difficulty are discussed.

Humeral hydatid cyst complicated with extraosseous involvement: a case of unusual location of echinococcosis

Hydatid disease is a parasitic disease most commonly caused by Echinococcus granulosus that seldom involves the skeleton and is still common in the countries of the temperate zones. We present an extremely rare case report of a young patient with humeral hydatid disease complicated with extraosseous involvement. Plain film of the left humerus demonstrated distortion of the axis, regional expansion of the humeral shaft with minimal thinning areas of the cortex. Additionally, numerous radiolucent areas of the humeral shaft were observed especially at the distal part of the bone. No calcification of the soft tissues was noticed. Computed tomography examination showed significant destruction of the trabecular bone of the humeral head and polycystic appearance of the bone marrow with regional calcifications into the lumen. Additionally, a large cystic lesion between medial and lateral head of the triceps muscle with some foci of calcifications were observed. Magnetic resonance imaging revealed the multiocular nature of the lesion into the humeral lumen with a cystic lesion involving the soft tissues of the upper arm. The cyst showed contrast enhancement at the pericyst capsule of the cyst after Gadolinium-DTPA administration.