Orbital hydatid cyst: Review of 10 cases

Orbital intramuscular hydatid cyst causing compressive optic neuropathy: a case report and literature review

BACKGROUND

Echinococcosis, commonly known as hydatid disease, is a zoonotic infection resulting from the tapeworm Echinococcus granulosus. The occurrence of hydatid cysts in the orbital region is uncommon, representing less than 1% of all reported hydatid cases. This report details a unique case of an intramuscular hydatid cyst in the orbital region that led to compressive optic neuropathy.

CASE PRESENTATION

A 22-year-old male from Kabul, Afghanistan presented with a five-month history of progressive proptosis in his left eye, associated with a gradual decrease in vision over the past three weeks. The left eye exhibited upward globe dystopia, ocular motility limitation, mild conjunctival injection, and chemosis. Diagnosis was achieved through imaging and histopathological examination. Treatment involves surgical removal of the cyst and prolonged albendazole therapy. The postoperative course showed significant improvement in the patient's condition and restoration of his vision.

CONCLUSIONS

Despite its rarity, this case underscores the importance of awareness and knowledge of hydatid disease among physicians, especially those working in endemic areas. It emphasizes the importance of including hydatid disease in the differential diagnosis of orbital masses, particularly in endemic regions.

A case and literature review of intraocular echinococcus causing bilateral visual loss in a HIV-infected patient

Although echinococcosis is a common parasitic disease endemic to Africa, ocular echinococcosis is rare. We present a case of intraocular echinococcosis in a HIV-infected patient. A 38-year-old South African HIV-infected woman presented to a district-level hospital in Kwa-Zulu Natal on 10 March 2020. Her main presenting complaint was that of progressive, painless, bilateral visual loss. A B-ultrasonography scan revealed tractional retinal detachment on the right eye, while the left eye had tractional bands with a ‘double-walled’ cystic cavity causing retinal traction. A systemic work-up revealed a positive Echinococcus ELISA IgG with a value of 1.3, eosinophilia of 5.70% (0.41 × 109), and elevated C-reactive protein and erythrocyte sedimentation rate of 47 mg/L and 93 mm/hr, respectively. Based on the above clinical, biochemical and ultrasonographical evidence, a diagnosis of ocular echinococcosis was made. Our differential diagnosis includes toxic optic neuropathy, Jarisch-Herxheimer-like reaction secondary to immune reconstitution and necrotizing herpetic retinitis. She was initiated on topical and intravitreal steroids which led to decreased intraocular inflammation and dry maculae. Five months after presentation, her visual acuity remained unchanged with no light perception in both eyes. We conclude that ocular echinococcosis, although rare, can lead to severe visual impairment as there are no known definite treatment modalities for intraocular hydatid disease. Reports on co-infections with HIV and Echinococcus are limited with a potential scope for research.

Successful eradication of a large orbital hydatid cyst without rupture using fronto-orbitozygomatic approach, the first case reported from Syria

Hydatid disease is a parasitic infection resulted by Echinococcus granulosus in the larval stage and is most prevalent in the Middle East, India, Africa, South America, New Zealand, Australia, Turkey and Southern Europe. However, orbital hydatid cysts are rare and represent a challenge to the surgeon to eradicate the cyst without rupture. Here, we report a case of a relatively large primary intraconal orbital cyst in a 21-year-old woman. We managed to eradicate the cyst without any complication using fronto-orbitozygomatic approach, and the patient remained disease free after the 3 months of follow-up.

The surgery of intra-orbital hydatid cyst: a case report and literature review

Intra-orbital hydatid cyst is a very rare pathological entity that affects children and the young adults; it is secondary to the development in the orbit of the echinococcus granulosis tapeworm. Its frequency does not exceed 1% of all cases of hydatid disease. Clinical presentation of intra-orbital hydatid cyst is dominated by proptosis and a decrease in visual acuity, complete surgical excision is difficult, evolution is generally better when the treatment is early before the installation of irreversible optic atrophy. We report one case of a 3 years old girl operated for right intra-orbital hydatid cyst who presented with proptosis and blindness. Complete removal was difficult and puncture of the cyst was performed followed by excision of its membrane with good post-operative results. We also discuss the different epidemiological, clinical, radiological and therapeutic aspects of intra-orbital hydatid cyst and a review of literature of this rare pathology.

A rare case of giant primary orbital hydatid cyst

BACKGROUND

Primary orbital involvement is extremely rare in echinococcosis. We report a case of giant orbital hydatid cyst in a 15-year-old boy.

CASE DESCRIPTION

A 15-year-old boy presented with left-side proptosis and gradual painless vision loss. Computed tomography and magnetic resonance imaging revealed a giant multilocular cystic orbital lesion extending into subfrontal region. Surgical excision was done. Histopathology was suggestive of hydatid cyst. Postoperatively, an antiparasitic agent was administered for 3 months.

CONCLUSIONS

Hydatic cyst should be kept in differential diagnosis of orbital cystic lesions, especially in pediatric population and endemic areas.

Orbital cystic schwannoma masquerading as hydatid cyst

Gradually increasing abaxial proptosis in a middle-aged female patient revealed a large well-defined cystic lesion behind the globe extending till the orbital apex. B scan ultrasound and CT findings were favouring a diagnosis of orbital hydatid cyst. Thus as a diagnostic/curative surgical protocol, the cystic lesion was removed in total. However, intraoperative gross specimen examination was not classical of hydatid cyst, thus a further histopathological evaluation was carried out, which confirmed the diagnosis of orbital schwannoma with extensive cystic degeneration. Postoperatively the clinical course was uneventful at the end of 1 year.

Subretinal echinococcosis: a case report

BACKGROUND

Echinococcosis is a dangerous zoonotic parasitic disease. Ocular echinococcosis is very rare, especially the hydatid cysts in subretinal space. We present a case of subretinal echinococcosis and management.

CASE PRESENTATION

A 37-year-old man with subretinal echinococcosis who developed panuveitis and visual impairment. The patient lives on agriculture and animal husbandry, which made him susceptible to parasitic infection. He had severe panuveitis and blurred vision on arrival at hospital. According to his ocular examination and systemic review, the subretinal echinococcosis diagnosis was made. The patient received pars plana lensectomy and pars plana vitrectomy. The lesion underneath his retina was removed, and histopathology examination confirmed the subretinal echinococcosis diagnosis.

CONCLUSIONS

Echinococcosis is a dangerous zoonotic parasitic disease in pastoral areas. Ocular echinococcosis is usually secondary to systemic infection. Although the incidence is rare, the disease could lead to destructive visual function impairment.

Orbital Hydatid Cyst Causing Papilledema and Proptosis in an Adult

Hydatid cyst is an infectious disease caused by Echinococcus granulosus, primarily involving the liver and lungs. The orbit is an extremely rare site for involvement with hydatid cyst. We present a 36-year-old man with unilateral visual loss, proptosis, and papilledema caused by an orbital hydatid cyst.

Echinococcus in the orbit: an unusual hideout

Isolated involvement of the orbit by hydatidosis is extremely rare. It is a parasitic infestation due to a tapeworm called Echinococcus Granulosus. It is an uncommon disease in head and neck region as it commonly manifests in the lungs and liver. When seen in head and neck, it has been found in the orbit, paranasal sinuses and salivary glands. Orbital hydatidosis per se forms only 1% of all types of hydatid disease. It is endemic in Africa, Middle East and Southeast Asian countries including India. In orbital hydatid disease, patients usually present with unilateral proptosis and diminution of vision. Proptosis is classically painless. Total surgical removal remains the mainstay of treatment. A 30-year-old female belonging to lower socio-economic status, presented with left eye proptosis since 2 years. There was a gradual increase in proptosis associated with diminution of vision over the last 4 months. This finally led to complete loss of vision in a period of two months. Computed tomography scan showed two soft homogenous non-enhancing cystic structures present in the orbit abutting the optic nerve without any intracranial extension; most likely differentials are a developmental cyst, hydatid cyst, epidermoid cyst, rhabdomyosarcoma or a nerve sheath tumor. Magnetic resonance imaging showed two T1 hypointense non-enhancing, T2 hyperintense soft cystic capsulated space-occupying lesions present in the extraconal compartment of orbit abutting the optic nerve, likely to be lymphangioma or a hydatid cyst. Surgery was planned and endoscopic orbital decompression was done. Sago grain-like granules were seen pouring out of the cysts. Cyst walls were completely removed in piecemeal and the specimen was sent for histopathology. Immediate intra-operative reduction of proptosis was seen. The final histopathological report was suggestive of hydatid cyst.

An orbital hydatid cyst involving inferior rectus muscle: A case report

The orbital hydatid cyst is a rare entity and although most of them are located in superolateral and superomedial angles of orbits, involvement of inferior sites is uncommon. We report a 12-year-old case of primary hydatid cyst situated in inferior rectus muscle which was undergone surgical removal. Magnetic resonance imaging (MRI) was used for differential diagnosis of hydatid cyst. Moreover, histological analysis was performed, after the cyst removal, to confirm the diagnosis. Early clinical and radiological evaluations and subsequent surgical excision is the mainstay of treatment and should be performed to prevent severe complications caused by the advanced and ruptured cysts.

Large primary intraorbital hydatid cyst in elderly

We report a case of solitary, primary intraorbital hydatid cyst in a elderly female aged 80 years who presented with nontender, nonpulsatile proptosis of left eye with diminution of vision. MRI scan of the head and the orbits, revealed a retro-bulbar cyst. Surgical excision was performed by employing a lateral orbitotomy approach. Histopathology report confirmed hydatid cyst.

Orbital hydatid cyst

Hydatid cysts rarely appear isolated in the orbital cavity without involvement of other organs. Most of these are situated in the superolateral and superomedial angles of the orbit. Inferiorly located cysts are very uncommon. The authors report a case of a primary hydatid cyst of the orbit with inferiolateral localization. The cyst was enucleated surgically via a rhinotomy approach. This case was considered as a primary infection, because there was no previous history of hydatid disease and no findings of liver and lung cysts on radiological examination. Physicians should include orbital hydatid cyst in the differential diagnosis of unilateral proptosis. To avoid complications that might occur during surgery, the cyst can be easily removed using a gentile enucleation technique.