Adductor magnus muscle primary hydatid cyst rare unusual site: A case report

Primary intermuscular hydatid cyst: A common disease at unusual location: Case report

Hydatid cyst is a parasitic infection caused by the Echinococcus granulosus and multilocularis species of tapeworm. An intermuscular hydatid cyst is an unusual location for hydatid cyst disease, even in endemic regions. Therefore, intermuscular hydatid cysts might be mistaken for other benign and malignant soft tissue tumors. Magnetic resonance imaging plays a crucial role in diagnosing intermuscular hydatid cysts by showing the typical imaging characteristics of the disease. Here, we report a case of an isolated intermuscular hydatid cyst disease in a 34-year-old man who presented with left posterior thigh swelling of 5 years duration. The diagnosis was established using magnetic resonance imaging, which showed large, well-encapsulated cystic lesions containing multiple daughter cysts of varying sizes, with some cysts containing detached floating membranes. Surgery was performed, together with preoperative and postoperative albendazole treatment.

Hydatid Disease With Psoas and Gluteal Muscle Involvement Causing Cauda Equina Compression: A Case Report

Hydatid disease is a zoonotic infection caused by the Echinococcus granulosus tapeworm, primarily affecting the liver and lungs, and rarely involving muscle tissue. Humans are infected by ingesting eggs from contaminated food or water. Patients may present with painless, slow-growing masses, sometimes associated with nerve or vessel compression, especially in cases of muscle involvement. Diagnostic imaging techniques such as ultrasonography, CT scan, and MRI are essential for preoperative evaluation. Treatment involves surgical removal of the cyst with careful lavage to prevent recurrence, followed by anti-parasitic medication. Our case involves a young female with a previously treated pulmonary hydatid cyst, who presented later with numbness and pain in her left lower limb, revealing a psoas location of hydatid disease exerting direct compression of the cauda equina. This case underscores the importance of including hydatid disease as a potential differential diagnosis for soft tissue masses in endemic areas, even with an atypical clinical presentation.

Giant muscle hydatid in lower extremity: a rare case with neurological symptoms as the first manifestation

BACKGROUND

Human hydatid disease typically occurs in organs such as the liver and kidney. Primary solitary intramuscular hydatid disease, however, is rare.

CASE PRESENTATION

We report a case of a giant muscle hydatid in the lower extremity, with neurological symptoms as the first manifestation. The symptoms specifically manifested as intermittent pain in the right lower extremity and numbness in the sole of the right foot. However, there were no obvious abnormalities detected in electromyography and lumbar MRI. Subsequent ultrasonography and calf MRI showed that the patient had cystic lesions in the calf. The patient was initially diagnosed with a muscle hydatid cyst. Treatment involved complete surgical excision of the lesion, and the diagnosis of a hydatid cyst was confirmed through macroscopic and microscopic histopathological examination after the mass was excised. The patient was given oral albendazole, and no recurrence was observed during the 12 months of follow-up.

CONCLUSIONS

This case underscores the need to consider hydatid disease when diagnosing soft tissue masses in muscles, particularly in endemic areas. Patients may initially present with atypical symptoms like peripheral nerve issues.

Don't miss it: Extremity-located cyst hydatid may mimic soft tissue tumors

OBJECTIVES

In this study, we present our experience in patients with hydatid cysts located intramuscularly.

PATIENTS AND METHODS

Between May 2018 and May 2023, a total of 11 patients (3 males, 8 females; mean age: 29.1±13.6 years; range, 8 to 56 years) with intramuscular hydatid cysts were retrospectively analyzed. Demographic data, laboratory values, serological test results, location and size of the cyst, radiological imaging findings, and complications were recorded.

RESULTS

The mean follow-up was 44.3±17.3 (range, 5 to 60) months. The mean mass size at the time of admission was 5.4±3.3 (range, 2 to 14) cm. Serologic tests were positive in the majority of cases (72.7%). Eosinophilia was negative in 72.7% patients. The rate of isolated muscle involvement was 81.8%. The rate of lower extremity involvement was 72.7%. The most common involvement was leg (36.4%), thigh (18.2%), and shoulder (18.2%). One patient developed compartment syndrome after cyst rupture during neoadjuvant antihelmintic therapy. There was no recurrence in any of the patients.

CONCLUSION

Hydatid cysts should be considered in the differential diagnosis of slowly growing, deeply located, painless soft tissue masses, particularly in endemic areas. Although it is a rare complication, compartment syndrome may develop after spontaneous cyst rupture. Neoadjuvant antihelmintic chemotherapy can reduce complications. The combination of total surgical excision and chemotherapy yields successful results in the treatment of hydatid cysts located in the muscle.

Primary Hydatid Cyst of the Thigh: Atypical Location and Perioperative Strategies to Minimize Recurrence After Accidental Cyst Rupture

This study presents a rare case of hydatid cyst (HC) located in the left thigh, an atypical site for this parasitic infection, which typically affects the liver and lungs. A 22-year-old female presented with a gradually increasing swelling in the anterior aspect of her left thigh over a period of six months. The diagnosis of the thigh HC was established through a combination of imaging techniques, including ultrasonography and magnetic resonance imaging (MRI), and serological tests. The patient underwent surgical removal of the cyst. We also highlight a management strategy for perioperative accidental rupture of the cyst to minimize the risk of dissemination and reduce the likelihood of recurrence. This report emphasizes the need for a careful multidisciplinary approach to ensure effective diagnosis and successful management of HC, particularly when they occur in atypical locations.

Muscle hydatid diseases: percutaneous treatment with Örmeci technique

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.

An Iranian man with increased thigh mass due to a hydatid cyst

Background: Hydatid cyst is a zoonotic infection caused by Echinococcosis granulosus. Primary single-intramuscular hydatid disease is rare, even in endemic regions of the world. Here we report the case of exceptional thigh mass due to a hydatid cyst in an Iranian man.

Case presentation: An 86-year-old man, initially presented to Velayat teaching hospital surgery clinic in May 2017 with a single right-thigh mass, but physical examinations of other organs were unremarkable. Based on sonographic findings, the differential diagnosis was hydatid cyst. He underwent surgical resection of the cyst. Histopathological results confirmed the diagnosis. There was no evidence of recurrence of the lesion during the 23-month follow-up.

Conclusion: Increase thigh mass due to a hydatid cyst is a rare event. In endemic regions with the presence of hydatid cysts, especially physicians of surgical clinics have to consider differential diagnosis of hydatid cysts in unusual locations in case of such a lesion.

Primary hydatid cyst in the adductor magnus muscle

Human hydatid cyst is a zoonotic disease caused by the larvae of the Echinococcus species, most commonly the Echinococcus granulosus. Although hydatid cyst can cause disease almost anywhere in the human body, it most commonly affects the liver and lungs. Primary musculoskeletal hydatid involvement is a very rare occurrence even in endemic regions. Musculoskeletal hydatid disease shows no pathognomonic clinical signs and symptoms. And the contribution of serology to the diagnosis is negligible due to the high rate of false-negative results. Therefore, radiological imaging studies have a critical role in the diagnosis of the disease. To the best of our knowledge, there are only a few case reports of primary hydatid involvement of the adductor magnus muscle in the current literature. Here we present a 55-year-old female patient with primary hydatid cyst in the adductor magnus muscle and discuss the case in terms of imaging.