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Paspala A, Mela E, Vailas M, Nastos K, Dellaportas D, Kykalos S, Machairas N, Schizas D. Primary Hydatid Cysts in the Extremities: A Systematic Review of the Literature. Cureus 2024; 16:e63174. [PMID: 39070504 PMCID: PMC11273176 DOI: 10.7759/cureus.63174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/25/2024] [Indexed: 07/30/2024] Open
Abstract
Primary hydatid cysts (PHCs) in the extremities are uncommon, presenting in the majority of cases with atypical clinical features. Radical surgical excision remains the mainstay of treatment. The aim of our study was to accumulate the already published data on PHCs in the extremities in terms of demographic, diagnostic, and therapeutic aspects. Three electronic databases were meticulously searched for articles published until 2024. A total of 85 studies comprising 118 patients were finally included in our review. Sixteen patients (13.5%) were diagnosed with a hydatid cyst in their upper extremity, 94 (79.7%) with a PHC in the lower extremity, and eight (6.8%) with an echinococcal cyst in the axilla. Pain and swelling were the most frequent symptoms, whereas only two patients were completely asymptomatic. The mean lesion size was 11.6 ± 7.1 cm. Preoperative serology investigation was reported in 82 out of 118 (69.5%) patients; among them, 33 (44.6%) cases had a positive preoperative serology test. The vast majority of patients (96.6%) were treated with an interventional procedure either surgical or radiological, and only seven experienced postoperative complications. No anaphylactic reaction was described perioperatively. Although preoperative diagnosis of PHCs is challenging, they should be considered in the differential diagnosis of soft tissue lesions. Treatment strategies should be individualized on a patient basis, while radical surgical excision remains the gold standard treatment.
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Affiliation(s)
- Anna Paspala
- Department of Surgery, Evgenideio Hospital, Athens, GRC
| | - Evgenia Mela
- First Department of Surgery, Laiko General Hospital, Athens, GRC
| | - Michail Vailas
- First Department of Surgery, Laiko General Hospital, Athens, GRC
| | | | | | - Stylianos Kykalos
- Second Propaedeutic Department of Surgery, Laiko General Hospital, Athens, GRC
| | - Nikolaos Machairas
- Second Propaedeutic Department of Surgery, Laiko General Hospital, Athens, GRC
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Siraj S, Nijrabi MM, Hakimi A, Zaki A, Hares R. Primary intramuscular thigh hydatid cyst: A case report. Int J Surg Case Rep 2023; 109:108589. [PMID: 37517254 PMCID: PMC10407430 DOI: 10.1016/j.ijscr.2023.108589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 07/22/2023] [Accepted: 07/24/2023] [Indexed: 08/01/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Hydatid cyst is a parasitic infection caused by Echinococcus granulosis. It mostly involves the liver and lungs; however, muscle involvement is an uncommon event. The diagnosis of such cystic masses is still a challenge due to the presence of more common pathological conditions in soft tissue. Imaging is useful and can identify a definitive diagnosis. CASE PRESENTATION We present a case of a 32-year-old woman with history of close contact with dogs and cats, who complained of an isolated swelling in the right upper thigh growing gradually over a period of 3 years. Ultrasound reported intramuscular hydatid cyst in the right thigh. Hydatid cyst was completely excised. The outcome was good, with no recurrence in one year. CLINICAL DISCUSSION Ultrasonography is an excellent and cost-effective imaging modality with a high negative predictive value in the evaluation of palpable superficial soft-tissue masses and hydatid cysts. CONCLUSION Isolated intramuscular hydatid cyst is rarely reported, even in endemic areas of the disease, so the diagnosis should be considered in any cystic masses of soft tissue, particularly in subjects from high-endemic zones. Although the treatment of choice in such cases is surgical excision but prevention is more favorable to fight against hydatid disease.
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Affiliation(s)
- Salahuddin Siraj
- Department of Orthopaedic, French Medical Institute for Mothers and Children, Kabul, Afghanistan
| | - Mirza Mohammad Nijrabi
- Department of Orthopaedic, French Medical Institute for Mothers and Children, Kabul, Afghanistan
| | - Ahmadullah Hakimi
- Department of Pathology and Clinical Laboratory, French Medical Institute for Mothers and Children, Kabul, Afghanistan
| | - Adil Zaki
- Department of Radiology, French Medical Institute for Mothers and Children, Kabul, Afghanistan
| | - Roohullah Hares
- Department of Paediatric Surgery, French Medical Institute for Mothers and Children, Kabul, Afghanistan.
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Alvi MA, Ali RMA, Khan S, Saqib M, Qamar W, Li L, Fu BQ, Yan HB, Jia WZ. Past and Present of Diagnosis of Echinococcosis: A Review (1999-2021). Acta Trop 2023; 243:106925. [PMID: 37080264 DOI: 10.1016/j.actatropica.2023.106925] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 03/17/2023] [Accepted: 04/08/2023] [Indexed: 04/22/2023]
Abstract
The larval forms of taeniid cestodes belonging to the genus Echinococcus are the source of the zoonotic infection known as echinococcosis. Alveolar and cystic echinococcosis are caused by Echinococcus multilocularis and Echinococcus granulosus (s. s) respectively. It is endemic in several regions of the world. In this systematic review, we describe diagnosis, and the species (human, canids, livestock, and small rodents) affected by cystic (CE) and alveolar echinococcosis (AE). From 1999 to 2021, we searched the online directory through PubMed, SCOPUS, Web of Science, and google scholar. Among the 37,700 records found in the online databases, 187 publications met our eligibility requirements. The majority of investigations employed a range of diagnostic methods, such as ELISA, imaging, copro-PCR, necropsy or arecoline hydrobromide purgation, morphological cestode confirmation, and fecal sieving/flotation to detect and confirm Echinococcus infection. ELISA was the most commonly used method followed by PCR, and imaging. The research team retrieved data describing the incidence or assessment of the diagnostic test for E. multilocularis in humans (N = 99), canids (N = 63), small ruminants (N = 13), large ruminants (N= 3), camel (N= 2), pigs (N=2) and small mammals (N= 5). This study was conducted to explore the diagnostic tools applied to detect echinococcosis in humans as well as animals in prevalent countries, and to report the characteristic of new diagnostic tests for disease surveillance. This systematic review revealed that ELISA (alone or in combination) was the most common method used for disease diagnosis and diagnostic efficacy and prevalence rate increased when recombinant antigens were used. It is highly recommended to use combination protcols such as serological with molecular and imaging technique to diagnose disease. Our study identified scarcity of data of reporting echinococcosis in humans/ animals in low-income or developing countries particularly central Asian countries. Study reports in small rodents indicate their role in disease dissemination but real situation in these host is not refected due to limited number of studies. Even though echinococcosis affects both public health and the domestic animal sector, therefore, it is important to devise new and strengthe implementation of the existing monitoring, judging, and control measures in this estimate.
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Affiliation(s)
- Mughees Aizaz Alvi
- State Key Laboratory of Veterinary Etiological Biology, College of Veterinary Medicine, Lanzhou University, National Para-reference Laboratory for Animal Echinococcosis, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, China; Department of Clinical Medicine and Surgery, University of Agriculture, Faisalabad, Pakistan
| | - Rana Muhammad Athar Ali
- Department of Clinical Medicine and Surgery, University of Agriculture, Faisalabad, Pakistan
| | - Sadiq Khan
- Department of Clinical Medicine and Surgery, University of Agriculture, Faisalabad, Pakistan
| | - Muhammad Saqib
- Department of Clinical Medicine and Surgery, University of Agriculture, Faisalabad, Pakistan
| | - Warda Qamar
- Department of Parasitology, University of Agriculture, Faisalabad, Pakistan
| | - Li Li
- State Key Laboratory of Veterinary Etiological Biology, College of Veterinary Medicine, Lanzhou University, National Para-reference Laboratory for Animal Echinococcosis, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, China
| | - Bao-Quan Fu
- State Key Laboratory of Veterinary Etiological Biology, College of Veterinary Medicine, Lanzhou University, National Para-reference Laboratory for Animal Echinococcosis, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, China
| | - Hong-Bin Yan
- State Key Laboratory of Veterinary Etiological Biology, College of Veterinary Medicine, Lanzhou University, National Para-reference Laboratory for Animal Echinococcosis, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, China.
| | - Wan-Zhong Jia
- State Key Laboratory of Veterinary Etiological Biology, College of Veterinary Medicine, Lanzhou University, National Para-reference Laboratory for Animal Echinococcosis, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, China; Jiangsu Co-innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou, China.
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Arian M, Kazerani M. Primary hydatid cyst in the adductor muscles of thigh: A case report. Clin Case Rep 2022; 10:e6664. [PMID: 36483881 PMCID: PMC9723479 DOI: 10.1002/ccr3.6664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 11/13/2022] [Indexed: 12/12/2022] Open
Abstract
Hydatidosis rarely (2%-3% of all cases) manifests as an intramuscular mass in endemic areas. This 55-year-old farmer with an asymptomatic thigh mass from 35 years ago presented with exertional pain in the last 40 days of the disease course. The patient started on albendazole and was cured with surgery.
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Affiliation(s)
- Mahnaz Arian
- Department of Infectious Diseases, Faculty of MedicineMashhad University of Medical SciencesMashhadIran
| | - Marzieh Kazerani
- Department of Infectious DiseaseMashhad Islamic Azad University of Medical SciencesMashhadIran
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ÖRMECİ N, ASİLLER ÖÖ, YAĞCI C, ÖRMECİ T, ELLİK Z, KALKAN Ç, İLHAN A. Muscle hydatid diseases: percutaneous treatment with Örmeci technique. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2022. [DOI: 10.32322/jhsm.1011096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Aim: To present results of percutaneous treatment with Örmeci technique for muscle hydatid diseases.
Material and Method: Twelve patients (9 male, 3 female) with 16 hydatid cysts (10 CE Type 1, 6 CE Type3B) were treated by percutaneous treatment with Örmeci technique. The percutaneous puncture was performed under sonographic guidance using a 22-gauge Chiba needle as a one-step procedure in CE type 1 and 3A. However, two to six Chiba needles according to size of the cysts were used in different locations at the same time in the cyst of CE type 2, and 3B). For every 1 cm of the long diameter of the cyst lesion, 3cc of fluid from the cysts was aspirated, which was almost the same amount of cc in volume for the CE type 1 and CE type 3A hydatid cysts. A 2cc of pure alcohol (96 %) and 1cc of polidocanol 1% (ethoxysclerol 1%, Kreussler Pharma, Wiesbaden, Germany) were injected into the cysts right after the aspiration of CE type 1 and type 3A, without the aspiration of CE type 2 and 3B, for each centimeter of the long diameter of the cysts. The total amount of pure alcohol and polidocanol were injected equally among the CE type 2 and type 3B cyst’s needles. It was waited for five minutes for all scolexes to be killed and the needle/or needles were taken back. The patients with hydatid disease were followed up mean 34.75 ±14.39 (maximum 65-minimum 15) months.
Findings: Fifteen out of 16 hydatid cysts (93.75%) cured. We had two complications of treatment. One patient had an abscess in the cyst after the percutaneous treatment. After the percutaneous drainage, patient was cured well, and he had no symptoms during the follow up. Another patient had torpidity in his leg after the treatment. After three months, he had no symptoms.
In Conclusion, Percutaneous treatment with Örmeci technique is outpatient based, successful, safe, repeatable, cheap and It can be used as an alternative treatment in selected patients.
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Affiliation(s)
| | | | - Cemil YAĞCI
- ANKARA UNIVERSITY, ANKARA FACULTY OF MEDICINE
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Khasawneh RA, Mohaidat ZM, Khasawneh RA, Zoghoul SB, Henawi YM. Unusual intramuscular locations as a first presentation of hydatid cyst disease in children: a report of two cases. BMC Pediatr 2021; 21:371. [PMID: 34465295 PMCID: PMC8406844 DOI: 10.1186/s12887-021-02843-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 08/17/2021] [Indexed: 12/23/2022] Open
Abstract
Background Hydatid disease is an endemic disease in many countries of the world including the Middle East. It mainly affects the liver and lungs. Intramuscular hydatid disease is rarely reported in children. Such uncommon localization of hydatid cyst may pose difficulties in the clinical and radiological diagnosis; hence affecting patient’s management and outcome even in endemic areas. Case presentation We herein describe intramuscular hydatid cysts in 2 different children. The first case is a 5-year-old boy who presented with a painless palpable lump over the right lumbar paraspinal region. His history was remarkable for sheep contact. His laboratory results revealed a mild increase in white blood cell (WBC) count and C-reactive protein. The lesion showed typical features of a hydatid cyst on ultrasound. Further imaging including ultrasound of the abdomen and CT of the chest, abdomen, and pelvis showed infestation of the liver and lung as well. The lesions were resected surgically without complications. The patient received Albendazole preoperatively and after surgery for 3 months. No evidence of recurrence was seen during follow-up. The second case is a 6-year-old girl who presented with an incidental palpable lump in her left thigh during her hospital admission for recurrent meningitis. Ultrasound and MRI imaging were performed demonstrating a unilocular cystic lesion in the left proximal rectus femoris muscle. A provisional diagnosis of hematoma vs. myxoma was given. Biopsy was performed and yielded blood products only. The lesion was resected surgically with a postoperative diagnosis of hydatid cyst. Blood tests performed afterward showed a positive titer for Echinococcus. The patient received Albendazole for 3 months. No evidence of recurrence was seen during follow-up. Conclusions Despite its rarity; skeletal muscle hydatid cyst should always be considered in the differential diagnosis of cystic muscle lesions in children in endemic areas even if imaging studies did not show any of the typical signs. This will improve patient outcome by preventing unnecessary cystic puncture which might lead to serious complications, such as anaphylaxis and local dissemination. Supplementary Information The online version contains supplementary material available at 10.1186/s12887-021-02843-5.
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Affiliation(s)
- Ruba A Khasawneh
- Department of Diagnostic Radiology and Nuclear Medicine, Faculty of Medicine, King Abdullah University Hospital, Jordan University of Science and Technology, Irbid, 22110, Jordan.
| | - Ziyad M Mohaidat
- Orthopedic Division, Special Surgery Department, Faculty of Medicine, Jordan University of Science and Technology, Irbid, 22110, Jordan
| | - Rawand A Khasawneh
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, 22110, Jordan
| | - Sohaib B Zoghoul
- Radiology Department, Hamad Medical Corporation (HMC), Doha, Qatar, 00000
| | - Yousef M Henawi
- Department of Diagnostic Radiology and Nuclear Medicine, Faculty of Medicine, King Abdullah University Hospital, Jordan University of Science and Technology, Irbid, 22110, Jordan
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Khatami SH, Taheri-Anganeh M, Movahedpour A, Savardashtaki A, Ramezani A, Sarkari B, Mostafavi-Pour Z. Serodiagnosis of human cystic echinococcosis based on recombinant antigens B8/1 and B8/2 of Echinococcus granulosus. J Immunoassay Immunochem 2020; 41:1010-1020. [PMID: 32795213 DOI: 10.1080/15321819.2020.1807359] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND Cystic echinococcosis (CE) is a widespread parasitic disease caused by the larval stage of Echinococcus granulosus. Since current methods for the diagnosis of CE are not efficient enough, rapid, and reliable tests are required for the acceleration of CE diagnosis. The present study aimed to produce recombinant B8/1 and B8/2 antigens of E. granulosus and evaluate their sensitivities and specificities separately and simultaneously for the diagnosis of CE. METHODS The recombinant B8/1 and B8/2 antigens were produced and used in an ELISA system for the diagnosis of CE. The sera specimens including 30 sera from pathologically confirmed CE patients, 30 from other non-CE patients, and 30 from healthy controls, were evaluated by the ELISA, using AgB8/1 and AgB8/2. RESULTS The results showed a sensitivity of 93.33%, 90%, and 96.7% for AgB8/1, AgB8/2, and their combination, respectively. The specificities were 91.7%, 93.33%, and 93.33% for AgB8/1, AgB8/2, and their combination, respectively. CONCLUSION Simultaneous usage of AgB8/1 and AgB8/2 increased the test sensitivity for the diagnosis of CE. Furthermore, the specificity of AgB8/1 and AgB8/2 combination was more than AgB8/1 and equal to AgB8/2 alone. The findings revealed that the simultaneous usage of AgB8/1 and AgB8/2 could be a suitable approach for the diagnosis of CE.
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Affiliation(s)
- Seyyed Hossein Khatami
- Recombinant Proteins Laboratory, Department of Biochemistry, School of Medicine, Shiraz University of Medical Sciences , Shiraz, Iran
| | - Mortaza Taheri-Anganeh
- Cellular and Molecular Research Center, Research Institute on Cellular and Molecular Medicine, Urmia University of Medical Sciences , Urmia, Iran
| | - Ahmad Movahedpour
- Department of Medical Biotechnology, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences , Shiraz, Iran.,Student Research Committee, Shiraz University of Medical Sciences , Shiraz, Iran
| | - Amir Savardashtaki
- Department of Medical Biotechnology, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences , Shiraz, Iran.,Epilepsy Research Center, Shiraz University of Medical Sciences , Shiraz, Iran
| | - Amin Ramezani
- Department of Medical Biotechnology, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences , Shiraz, Iran.,Shiraz Institute for Cancer Research, Shiraz University of Medical Sciences , Shiraz, Iran
| | - Bahador Sarkari
- Department of Parasitology and Mycology School of Medicine, Shiraz University of Medical Sciences , Shiraz, Iran.,Basic Sciences in Infectious Diseases Research Center, School of Medicine, Shiraz University of Medical Sciences , Shiraz, Iran
| | - Zohreh Mostafavi-Pour
- Recombinant Proteins Laboratory, Department of Biochemistry, School of Medicine, Shiraz University of Medical Sciences , Shiraz, Iran.,Maternal-Fetal Medicine Research Center, School of Medicine, Shiraz University of Medical Sciences , Shiraz, Iran
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Sammet S, Dolff S. [Cystic echinococcosis - dog tapeworm. A big palpable subcutaneous tumor in the right thigh. Not always underlies a malignancy]. MMW Fortschr Med 2020; 162:45-48. [PMID: 32124345 DOI: 10.1007/s15006-020-0218-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Stefanie Sammet
- HPSTD Ambulanz, Klinik für Dermatologie und Venerologie Universitätsklinikum Essen, Hufelandstr. 55, D-45157, Essen, Deutschland.
| | - Sebastian Dolff
- Klinik für Infektiologie, Universitätsklinikum Essen, Deutschland
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Petit C, L'Ollivier C, Mattei JC, Menard A. Muscular hydatidosis. New Microbes New Infect 2020; 34:100637. [PMID: 31993206 PMCID: PMC6974779 DOI: 10.1016/j.nmni.2019.100637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 12/05/2019] [Accepted: 12/10/2019] [Indexed: 11/17/2022] Open
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