Hydatid cyst of the calf presenting as painless mass: A case report

Hydatid Cyst in Left Sub-Mandibular Space, an Unusual Location

Hydatid cysts in the neck area are considered as very rare and few cases have been reported in endemic areas. In the present study, we reported a 38-year-old female that underwent surgical operation for extraction of simple cyst in the submandibular area and the diagnosis of hydatid cyst was established by laboratory examinations. The patient was later diagnosed with hepatic hydatid cyst and received systemic treatments. We recommend that physicians should pay more attention to the possibilities of hydatid cysts in unusual areas in endemic regions especially Middle East.

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 Giant Hydatid Cyst of Lumbar Paraspinal Muscles

BACKGROUND

Hydatid cyst disease, commonly caused by Echinococcus granulosus, rarely occurs in paraspinal muscles. Among the few reported cases, the current case is the largest paraspinal hydatid cyst disease ever reported in literature with a review of management of such large lesions.

CASE DESCRIPTION

A 38-year-old male presented with lower back swelling for 1 year. Ultrasonography and magnetic resonance imaging scans suggested hydatidosis, following which the patient was taken up for surgery after preoperative medical therapy. En bloc resection was done, and histopathologic examination of the resected specimen confirmed the diagnosis. Postoperative albendazole was also used, and no recurrence was noted at 24 months post operation.

CONCLUSIONS

Hydatid disease should be kept as one of the differential diagnoses for back swelling, especially in endemic regions. Giant-sized hydatid cysts of paraspinal muscles, though rare, cannot be ruled out on clinical ground alone. Thorough history taking and detailed examination should be aided with radiologic investigations like magnetic resonance imaging for an accurate diagnosis. En bloc excision of the cyst combined with preoperative and postoperative medical therapy is an effective method of treating this condition and significantly reducing complication rates.

Hydatid cyst of the heart with mitral valve stenosis; Case report

Hydatid cyst of the heart is very rare, the left ventricle is the commonest site of myocardial involvement due to dominant left coronary vessels and thicker wall. Isolated cardiac involvement is extremely rare. Patients may be quite asymptomatic but the cyst may cause palpitation, dyspnea, chest pain, or when ruptured in to the cardiac or pericardial cavities may cause emergency presentations like anaphylactic reactions, sudden collapse due to pericardial tamponade or even sudden death.

A middle age female presented with exertional shortness of breath for 2 years. Echocardiography showed mitral valve stenosis. Computerized tomography scan of the chest showed a big complicated hydatid cyst arising from the wall of the right ventricle. Median sternotomy was done with excision of the hydatid cyst, and repair of mitral stenosis by commissurotomy. The patient received three cycles of albendazole for three months.

Surgery is the best options of treatment of cardiac hydatid disease, when the disease is affecting the pericardium complete excision may be possible, but when the myocardium is involved it may be difficult or even impossible to do complete excision, in this situation the cyst contents should be evacuated completely, preventing spillage is very mandatary to prevent recurrence. Care must be taken to avoid damage to the conductive system, the papillary muscles, the aortic and the mitral valves. Medical treatment with anthelminthic medications is used after surgery to reduce the recurrence rate.

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Hydatid cyst of the heart is a very rare clinical finding.

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It may be encountered during any other kinds of cardiac surgeries.

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The heart may be primarily affected of may be secondary to other organ involvement.

Hydatid cyst of the lumbar plexus: case report with review of literature

Background

Hydatid disease is widely distributed worldwide; it is caused by a parasite belonging to the Echinococcus species. It mostly affects the liver and the lungs, involvement of the spinal canal is reported to be around 0.2%, but affection of the peripheral nerves is extremely rare.

Case presentation

A 42-year-old lady was complaining from left loin pain and backache, with pain in the outer aspect of the left thigh for the last 5 years. During clinical examination, the ankle and the knee reflexes were normal and there was no muscle wasting. There was hyperesthesia on the outer aspect of the left leg.

Magnetic resonance imaging of the back demonstrated a cystic lesion between the 4th and the 5th lumbar vertebrae which was pushing the psoas muscle anteriorly and causing atrophy of the muscle. The patient received anthelminthic medications for 1 month before surgery with little improvement of the clinical and the radiological condition.

During surgery the cyst was found to arise from the lumbar nerve sheath and was apparent to be hydatid cyst because it was containing small daughter cysts. Isolation of the cyst was done and complete evacuation with deroofing of the cyst was done. The cavity of the cyst was irrigated with a solution of chlorhexidine as a scolicidal agent. The patient was discharged home after 3 days with no post-operative complications, anthelminthic medications prescribed for 3 months.

Conclusion

The treatment options vary depending on the region affected by the cyst; it may be treated by complete cyst excision, evacuation, and deroofing. Preventing spillage of the contents of the cyst during surgery and the use of scolicidal agents are mandatory to decrease the rate of recurrence. It is very important to exclude other organ involvement particularly pulmonary involvement before surgery.

Intra-peritoneal rupture of large hydatid cyst of the liver containing innumerable daughter cysts after blunt abdominal trauma

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Hydatid disease is a real health problem in endemic regions.

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The disease may be discovered incidentally during routine investigations.

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Intraperitoneal rupture is very serious that may result in severe anaphylactic reaction.

Introduction

Hydatid disease is a major health concern in the Mediterranean countries and many other parts of the world. The route of transmission is fecal-oral, and then spread by the portal venous system almost all part of the body.

The liver is the most commonly involved organ, followed by the lungs, and other organs are involved in order of decreasing frequency.

Presentation of case

A middle-age male patient presented with acute abdominal pain and repeated vomiting after blunt abdominal trauma. CT-scan showed a large hydatid cyst of the right lobe of the liver with features of intraperitoneal rupture. Emergency laparotomy was performed with extraction of a countless number of daughter cysts from the peritoneal cavity. We further examined the bowel and found no abnormalities. The cyst was not causing any compression on the bile duct. Omentoplasty was performed for the cavity. The patient was discharged home eight days after the operation and the drain removed after twenty-five days when the bile leak stopped, anthelminthic drugs were given for three months after the surgery.

Conclusion

Prevention of hydatid disease is the most effective way to control the disease, the cyst may reach a very large size and be asymptomatic. Intraperitoneal rupture may occur as a result of blunt abdominal trauma which could be trivial.

Primary infected hydatid cyst of the thigh in a young lady; case report with literature review

Hydatid disease present in certain parts of the world. Infection of the musculoskeletal system occur in less than 0.5%.

A 24-year-old lady had a painful mass in the inner aspect of the right thigh. MRI of the thigh showed a mixed signal intensity lesion measured about 65*100 mm, the mass was related to the muscle and the superficial femoral artery and its cavity had multiple septations.

During surgery an infected hydatid cyst of the muscle was found, evacuation was done with removal of the cyst. The patient was discharged next day and she received anthelminthic medications for 3 months.

Hydatid cyst of the muscles present with gradually enlarging mass or complications such as nerve compression, infection or rupture.

Treatment may be medical using anthelminthic medications. Complete surgical excision is the best surgical option; involvement of other organs should be excluded. Follow-up is recommended.

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Hydatid cysts could affect various body parts causing wide range of clinical presentations.

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Infection is one of the common complications of hydatid cysts.

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Surgery is the main treatment option in most of the cases.