Hydatid disease of the tarsal bones. A case report

Primary intraosseous mandibular hydatid cyst: A case report and review of 97 cases of osseous cystic echinococcosis

OBJECTIVE

In this study, we review the reported cases of hydatid disease of the bone in terms of etiology, pathogenesis, and histopathologic, serologic, and radiographic features and management of the disease.

STUDY DESIGN

The present case study reports an extremely rare occurrence of intraosseous hydatid cysts in the orofacial region, wherein symptoms or signs of systemic hydatid disease were absent. We discuss the challenges encountered during the diagnosis and treatment of osseous hydatidosis and reviewed articles on osseous hydatidosis, including 97 cases. We also compare the aspects reported in previous cases of mandibular hydatid cyst with those of the present case.

RESULTS

Hydatid cysts were found to be present in almost every bone of the skeleton in patients (mean age of 39.95 ± 19.67 years; range, 3-76 years). A slight male preference (58.8%) was observed. A history of rural lifestyle, animal bites, and trauma in the affected bone was reported. Only 5 reports on mandibular bone have been published previously, of which 3 were primary.

CONCLUSION

Because of the lack of usual presentations and radiographic features, the presence of hydatid cysts in unusual anatomic locations makes differential diagnosis difficult. The potential risk of anaphylactic shock in susceptible individuals, high recurrence rate, and risk of secondary hydatidosis pose diagnostic and surgical challenges.

Hydatid cyst of the foot: a case report

Background

Hydatid cyst is rarely located in soft tissues. This case of a hydatid cyst over the plantar surface of our patient’s foot is one of the rarest presentations.

Case presentation

This is a case report of a 22-year-old Somali who presented with a lump over the plantar surface of his foot of 1-year duration. The diagnosis of hydatid cyst was made intraoperatively from the typical appearance of a hydatid cyst. The cyst was completely excised. No local recurrence has been detected to date.

Conclusions

The rare location and uncommon incidence made the initial diagnosis of hydatid cyst of the foot difficult. Detection of the typical germinal membrane can guide the diagnosis of hydatid cyst in rare locations that are found incidentally.

Treatment of Bifocal Cyst Hydatid Involvement in Right Femur with Teicoplanin Added Bone Cement and Albendazole

Although bone involvement associated with cyst hydatid is rarely seen, it can cause unintended results such as high recurrence rate, infection, sepsis, or amputation of relevant extremity. Because of this reason, its treatment is difficult and disputed. In the case of bifocal bone cyst hydatid in right femur, along with albendazole treatment, result of resecting cyst surgically and its treatment with teicoplanin with added bone cement is given. In conclusion, since the offered treatment method both supports bone in terms of mechanical aspect and also can prevent secondary infection, the method is thought to be a good and safe treatment approach.

Recurrent iliac hydatidosis: A case report

INTRODUCTION

Hydatid cysts may occur in any area of the body, but they usually localize to the liver and the lungs. Primary localization in bone is not common.

PRESENTATION OF CASE

The authors report the case of multifocal hydatid disease appeared 3 years after the surgical treatment of a cyst of the hip. The patient presented with cough and chest pain of 2 months duration. Only the lung localization was symptomatic. The thoracic echography, the abdominal and chest scan allowed the diagnosis.

DISCUSSION

Hydatid recurrence remain frequent, whatever is the nature of the treatment, surgical or chemical.

CONCLUSION

The premature detection of recurrence is of great importance.

Tibial hydatidosis: a case report

Background

Hydatidosis is a tapeworm infection caused by the larval stage of Echinococcus species. The organs most frequently affected are the liver and the lungs. Primary involvement of the skeleton is rare. The location of hydatid cysts in the tibia is seldom described in the medical literature, and its diagnosis is challenging and often presenting with a pathologic fracture simulating benign bone cystic lesion.

Case presentation

We report a 53-year-old Tigrian woman who developed hydatid disease of the tibia.

Conclusion

The diagnosis of primary bone hydatid disease, especially tibial hydatidosis, is difficult and requires high index of suspicion. Hence, orthopedic surgeons should be aware of this disease. Moreover, it should be considered in preoperative differential diagnosis of destructive bone lesions especially in endemic areas.

Two cases of femoral hydatidosis secondary to canine tapeworm treated by albendazole and prosthetic reconstruction

Osseous hydatidosis is a very severe and recurrent complication of hydatidosis. The two cases reported here illustrate the severity of this invasive and destructive osseous parasitosis located at the femur and the hip joint, which required extensive resection and prosthetic reconstruction. The first case had a long history of liver and lung hydatidosis with a wide 'en-bloc' extra-articular resection of the right hip joint including the proximal femur; the second case had an 'en-bloc' total femur resection and total femur prosthesis. Preoperative and postoperative chemotherapy with albendazole was combined with surgery and was applied for many months. These two cases occurred several years after the incomplete treatments of recurrent lung or liver hydatidosis and might have been prevented if chemotherapy had been initially applied.

An unusual cause of knee pain in a young patient; hydatid disease of femur

INTRODUCTION

Osseous hydatid disease is a rare pathology and its differential diagnosis can be difficult.

PRESENTATION OF CASE

This article presents clinical and radiological findings of a femoral primary hydatid disease in a 23 year-old patient admitted with knee pain.

DISCUSSION

Osseous hydatid in femur is a rare entity. Curettage is one of the surgical options with high risk of anaphylaxis and implantation. Radical resection of involved segment is the preferred treatment method in the current literature. However, patient preference can be different.

CONCLUSION

Although late stages of this disease need be treated with amputation or disarticulation, in the early stages it can be treated with curettage and bone cementing. Our case with early diagnosis of hydatid disease of distal femur was treated successfully with curettage and bone cementing.

Primary muscular hydatidosis mimicking soft tissue tumour: a report of five cases

Primary muscular hydatidosis is rare and usually presents as an asymptomatic, slowly growing mass mimicking a soft tissue tumour. Adequate preoperative planning and wide excision is recommended, as incomplete excision may lead to anaphylactic reactions and local recurrence. It should be considered in the differential diagnosis of soft tissue tumours especially in regions endemic for the parasite.

Osseous hydatid disease

Hydatid disease is still endemic in several regions worldwide and is caused in most cases by the larval form of two species of the tapeworm Echinococcus: E. granulosus and E. multilocularis. Bone involvement is rare (0.2-4%), affecting the spine in almost half of the cases. The disease is usually silent until a complication (e.g. paraplegia or pathologic fracture) occurs. Many cases are diagnosed intraoperatively. Pre-operative diagnosis is based on radiological findings and serological assays, which lack high sensitivity and specificity. A high index of suspicion is necessary for the diagnosis, especially in patients that live in or travel to sheep-raising areas where hydatid disease is endemic. The treatment of choice is surgical, following the principles of a locally malignant lesion. Chemotherapy (albendazole alone or in combination with praziquantel) is used as an adjuvant treatment or when surgery is not possible. The prognosis is often poor, especially in the spine: most patients do not recover neurologically, the mortality and complication rate is high and many cases recur, as it is often impossible to radically excise the pathologic tissue.

Case report: Echinococcus disease of the bone presenting as a femoral shaft nonunion

Osseous hydatidosis (Echinococcus infection) is a rare parasitic bone infection that poses challenges in diagnosis and treatment. We present a novel case of osseous hydatidosis of the femoral shaft that was diagnosed at the time of surgery for a recalcitrant femoral shaft nonunion. We know of no reports of osseous hydatidosis presenting as a femoral shaft nonunion. A discussion of the challenges in diagnosis and treatment of osseous hydatidosis are discussed, and the literature on osseous hydatidosis is reviewed.