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Faraj C, Laasri K, Essetti S, Harras YE, Allali N, Haddad SE, Chat L, Aqqaoui L, Hosni S, Ettayebi F. Hydatid cyst of the humerus presenting as a suspicious lesion: A rare case report and review of literature. Radiol Case Rep 2024; 19:4526-4530. [PMID: 39188621 PMCID: PMC11345128 DOI: 10.1016/j.radcr.2024.07.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Revised: 07/04/2024] [Accepted: 07/05/2024] [Indexed: 08/28/2024] Open
Abstract
Hydatidosis is a parasitic disease caused by the tapeworm Echinococcus. Echinococcus Granulosus is the most common cause of hydatid disease in humans. Bone involvement is rare, accounting for only 0.9% to 2.5% of all cases. We report the case of an 8-year-old child admitted with right arm pain, revealing a hydatid cyst on the humerus. Lesion assessment revealed a hydatid cyst of the humerus with extension to the adjacent soft tissues. The surgical procedure involved the excision of the cyst along with drainage. In this case report, we review the epidemiological, clinical, and paraclinical aspects of the disease, as well as the treatment modalities. Bone hydatid disease is infiltrative, diffuse, slow, and progressive, making diagnosis late, and compromising the quality of treatment.
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Affiliation(s)
- Chaymae Faraj
- Pediatric Radiology Department, Children's Hospital, Mohammed V University, Rabat, Morocco
| | - Khadija Laasri
- Pediatric Radiology Department, Children's Hospital, Mohammed V University, Rabat, Morocco
| | - Sara Essetti
- Pediatric Radiology Department, Children's Hospital, Mohammed V University, Rabat, Morocco
| | - Yahya El Harras
- Pediatric Radiology Department, Children's Hospital, Mohammed V University, Rabat, Morocco
| | - Nazik Allali
- Pediatric Radiology Department, Children's Hospital, Mohammed V University, Rabat, Morocco
| | - Siham El Haddad
- Pediatric Radiology Department, Children's Hospital, Mohammed V University, Rabat, Morocco
| | - Latifa Chat
- Pediatric Radiology Department, Children's Hospital, Mohammed V University, Rabat, Morocco
| | - Loubna Aqqaoui
- Pediatric Surgery Department, Children's Hospital, Mohammed V University, Rabat, Morocco
| | - Sarah Hosni
- Pediatric Surgery Department, Children's Hospital, Mohammed V University, Rabat, Morocco
| | - Fouad Ettayebi
- Pediatric Surgery Department, Children's Hospital, Mohammed V University, Rabat, Morocco
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Serfaty A, Rodrigues TC. Musculoskeletal involvement in neglected tropical diseases: a comprehensive review. Skeletal Radiol 2024:10.1007/s00256-024-04595-6. [PMID: 38267762 DOI: 10.1007/s00256-024-04595-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 01/12/2024] [Accepted: 01/15/2024] [Indexed: 01/26/2024]
Abstract
Neglected tropical diseases (NTDs) encompass a group of diseases predominantly found in tropical regions, with origins dating back to their inclusion in the United Nations Millennium Development Goals in 2000. This initiative aimed to raise awareness and global funding to combat these diseases, which thrive in areas with limited sanitation, healthcare, and education. NTDs are caused by various pathogens such as bacteria, fungi, parasites, and viruses and affect over two billion individuals in resource-poor communities, leading to preventable deaths and devastating consequences. While the musculoskeletal system is only occasionally affected, the resulting chronic disabilities prevent individuals from working, posing a significant socioeconomic burden in this region of the world. Some NTDs exhibit distinct imaging features, and radiologists need to be aware of these characteristics to facilitate early treatment. In this review, we delve into musculoskeletal NTDs, focusing on clinical features and imaging findings, differential diagnosis, and clinical management.
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Affiliation(s)
| | - Tatiane Cantarelli Rodrigues
- Department of Radiology, Hospital do Coração (HCor), São Paulo, SP, Brazil
- ALTA Diagnostic Center (DASA Group), São Paulo, SP, Brazil
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Bahadure S, Hatgaonkar A, Bankar N, Sadavarte T, Tiwade Y, Rinait A. A Diagnostic Perplexity in Primary Pelvic Hydatid Disease, Mimicking Tumor and Tuberculosis: A Case Report. CLINICAL PATHOLOGY (THOUSAND OAKS, VENTURA COUNTY, CALIF.) 2024; 17:2632010X241253232. [PMID: 39070951 PMCID: PMC11282548 DOI: 10.1177/2632010x241253232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 04/20/2024] [Indexed: 07/30/2024]
Abstract
The differential diagnosis of cystic echinococcosis should be considered in the suspected case of a pelvic mass presenting with vague symptoms. Primary pelvic hydatid cyst is rare, and the achievement of early diagnosis is important, as the involvement of bone in the pelvis is difficult to treat, and the probability of recurrences is greater. This case report presents a rare case of a primary pelvic hydatid cyst in a male in his 30s. The patient presented vague symptoms of difficulty in micturition and chronic pelvic pain. First-line radiological imaging techniques diagnosed it as a neoplastic mass and tuberculosis, while MRI revealed it as a cystic disease, probably a hydatid cyst. Surgical excision and histopathological examination confirmed the diagnosis of a primary pelvic hydatid cyst. Acquaintance with the varied presentation of cystic echinococcosis helps to obtain an accurate diagnosis and thus decreases the severe complication associated with the disease. This case report highlights the importance of considering parasitic infections in the differential diagnosis of cystic pelvic masses, even in regions with low endemicity.
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Affiliation(s)
- Sweta Bahadure
- Department of Pathology, Datta Meghe Medical College Nagpur, Datta Meghe Institute of Higher Education and Research (DU), Wardha, India
| | - Anand Hatgaonkar
- Department of Radiodiagnosis, Datta Meghe Medical College Nagpur, Datta Meghe Institute of Higher Education and Research (DU), Wardha, India
| | - Nandkishor Bankar
- Department of Microbiology, Jawaharlal Nehru Medical College Nagpur, Datta Meghe Institute of Higher Education and Research (DU), Wardha, India
| | - Tejas Sadavarte
- Department of Radiodiagnosis, Datta Meghe Medical College Nagpur, Datta Meghe Institute of Higher Education and Research (DU), Wardha, India
| | - Yugeshwari Tiwade
- Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research (DU), Wardha, India
| | - Avinash Rinait
- Department of Surgery, Datta Meghe Medical College Nagpur, Datta Meghe Institute of Higher Education and Research (DU), Wardha, India
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Shrestha A, Shrestha AK, Deo A, Sharma GR. Intramuscular hydatid cyst of paraspinal muscle: A diagnostic challenge. Clin Case Rep 2023; 11:e8105. [PMID: 37900715 PMCID: PMC10600356 DOI: 10.1002/ccr3.8105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 09/18/2023] [Indexed: 10/31/2023] Open
Abstract
Hydatid cyst is a zoonosis caused by ingestion of eggs of Echinococcus-a tapeworm. Following ingestion of the eggs, oncosphere larvae are released which penetrate the intestinal wall to invade various organs of the body including liver, lungs, and skeletal muscles via. blood vessels. Due to their contractile nature and high lactic acid content, skeletal muscles are typically not a suitable site for attachment of hydatid cyst. In our case report presented below, we report a rare case of an isolated hydatid cyst of paraspinal muscle presenting as a slow-growing asymptomatic mass in the back, posing a clinical diagnostic dilemma.
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Affiliation(s)
- Anisha Shrestha
- Neurosurgery, Dirghayu Guru Hospital Pvt. Ltd.KathmanduNepal
| | | | - Alok Deo
- Neurological Surgery, Dirghayu Guru Hospital Pvt. LtdKathmanduNepal
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Neethu PK, Nanda S, Mohapatra J. Primary Pelvic Hydatid Cyst Mimicking an Ovarian Neoplasm: a Diagnostic Dilemma. Indian J Surg Oncol 2023; 14:69-71. [PMID: 36891413 PMCID: PMC9986403 DOI: 10.1007/s13193-022-01620-9] [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: 08/02/2021] [Accepted: 08/06/2022] [Indexed: 10/15/2022] Open
Abstract
Primary pelvic hydatidosis is a rare finding (incidence 0.2-2.25%). An 80-year-old, P6L6, lady presented to our hospital with complaints of PMB and abdominal pain of 5 days with a radiological diagnosis of an ovarian tumor. On pervaginal examination, a firm mobile mass of 6 × 6 cm was palpated in the anterior fornix. Suspecting torsion, semi-elective laparotomy was performed. A mass of 6 × 6 cm was seen arising from the pelvis, adherent to bowel loops, omentum, and bladder peritoneum. Hysterectomy with bilateral salpingo-oophorectomy was performed. No evidence of hydatid cyst was found in liver or any other organs. Final HP report was consistent with ovarian hydatid cyst.
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Affiliation(s)
- P. K. Neethu
- Department of Gynaecologic Oncology, AHRCC, Cuttack, India
| | - Sony Nanda
- Department of Gynaecologic Oncology, AHRCC, Cuttack, India
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Abstract
Background. Hydatid disease is a zoonosis caused by larval stages of cestodes belonging to the genus Echinococcus. The rib location is exceptional. It presents a real diagnostic and therapeutic challenge.
Objective. To describe the clinical, serological and radiological features and surgical management of rib hydatidosis.Methods. This is a retrospective study conducted over 4 years, on five cases of rib hydatidosis. We analysed the clinical and radiological presentations and the adopted therapeutic procedure.
Results. The average age of our patients was 44 years, without gender predominance. The clinical signs were dominated by the presence of an immobile swelling of fluid consistency without inflammatory sign, accompanied by moderate and intermittent localised pain. The laboratory assessment was nonspecific. The radiological assessment, including chest X-ray and thoracic computed tomography, with and without contrast, was essential in order to assess the extent of the lesion. Thoracic magnetic resonance imaging was requested in one case because of suspicions of a spinal extension. All of our patients underwent a rib excision accompanied by medical treatment of albendazole 24 hours after the surgery. The follow-up ranged from 1 year to 4 years and did not show any recurrence.
Conclusion. Hydatidosis of the ribs is an exceptional location of hydatid disease. The diagnosis was based on radiology and intraoperative exploration. The treatment remained essentially surgical by rib excision with anthelmintic drugs to prevent recurrence.
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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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Lal DN, Roza GDL, Damron TA. Total Femoral Replacement for Complicated Echinococcus Infection: Sixteen-Year Follow-up. JBJS Case Connect 2021; 11:01709767-202112000-00047. [PMID: 34762606 DOI: 10.2106/jbjs.cc.21.00408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
CASE Osseous hydatidosis caused by Echinococcus is rare, especially in long bones. To the best of our knowledge, this is the third femoral hydatidosis case with successful osseous eradication through total femoral resection and total femoral megaprosthesis. Unlike the previous 2 cases, we uniquely illustrate recurrent soft-tissue hydatidosis episodes requiring additional hydatid resections for local control with no evidence of disease at final 16-year follow-up, the longest follow-up period of the 3 reported cases. CONCLUSION Despite radical bone resection for osseous hydatidosis eradication, additional complex surgical interventions may be needed to locally control soft-tissue disease.
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Affiliation(s)
- Divakar N Lal
- Department of Orthopedic Surgery, Upstate Medical University, Syracuse, New York
| | | | - Timothy A Damron
- Department of Orthopedic Surgery, Upstate Medical University, Syracuse, New York
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El Haissoufi K, Ammor A, Kamaoui I, Benhaddou H. An Unusual Presentation of Hydatid Disease in a Child: A Case Report. Surg J (N Y) 2021; 7:e111-e115. [PMID: 34179459 PMCID: PMC8221841 DOI: 10.1055/s-0041-1731445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Accepted: 05/17/2021] [Indexed: 10/26/2022] Open
Abstract
The subcutaneous localization of the hydatid cyst in the abdominal wall is rarely encountered particularly in the pediatric population and is sometimes difficult to diagnose preoperatively. Here, we report the case of a 6-year-old boy who presented with two isolated episodes of low abundant hemoptysis and in whom a mass on the right lumbar region already considered as a lipoma was studied. Laboratory and radiological examinations were requested and the parietal cyst was surgically managed. The macroscopic and the pathological examination confirmed the diagnosis of the hydatid disease and helped in identifying the nature of the thoracic lesion that disappeared spontaneously after two episodes of hydatid vomiting. Hydatid cyst should be considered as a diagnosis for any masses of the abdominal wall. Moreover, biopsy and partial resection of the mass must be avoided.
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Affiliation(s)
- Kamal El Haissoufi
- Department of Pediatric Surgery "A," Mohammed VI University Hospital, Oujda, Morocco.,Faculty of Medicine and Pharmacy, Mohammed Ist University, Oujda, Morocco
| | - Abdelouhab Ammor
- Department of Pediatric Surgery "A," Mohammed VI University Hospital, Oujda, Morocco.,Faculty of Medicine and Pharmacy, Mohammed Ist University, Oujda, Morocco
| | - Imane Kamaoui
- Faculty of Medicine and Pharmacy, Mohammed Ist University, Oujda, Morocco.,Department of Radiology, Mohammed VI University Hospital, Oujda, Morocco
| | - Houssain Benhaddou
- Department of Pediatric Surgery "A," Mohammed VI University Hospital, Oujda, Morocco.,Faculty of Medicine and Pharmacy, Mohammed Ist University, Oujda, Morocco
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Gautam S, Patil PL, Sharma R, Darbari A. Simultaneous multiple organ involvement with hydatid cyst: left lung, liver and pelvic cavity. BMJ Case Rep 2021; 14:e241094. [PMID: 33509899 PMCID: PMC7845667 DOI: 10.1136/bcr-2020-241094] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2021] [Indexed: 01/30/2023] Open
Affiliation(s)
- Sandeep Gautam
- CTVS, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Prashant L Patil
- CTVS, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Rahul Sharma
- CTVS, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Anshuman Darbari
- CTVS, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
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11
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Gonder N, Demir IH, Kılıncoglu V. The effectiveness of combined surgery and chemotherapy in primary hydatid cyst of thigh muscles, a rare localization and its management. J Infect Chemother 2020; 27:533-536. [PMID: 33183964 DOI: 10.1016/j.jiac.2020.10.027] [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: 09/08/2020] [Revised: 10/20/2020] [Accepted: 10/24/2020] [Indexed: 10/23/2022]
Abstract
Hydatid cyst is a common infestation caused by helminths in humans and usually involves the liver and lungs. Primarily, cases of hydatid cysts in the thigh muscles are extremely rare and are generally in the form of case reports. It is an important disease due to its insidious course, its confusion with other soft tissue pathologies, delay in diagnosis and painstaking surgery. In our study, the largest case series in the literature, the clinical stages of the diagnosis, treatment and follow-up of 9 hydatid cysts that develop primarily in the thigh muscles were evaluated. The risk of recurrence in primary hydatid cyst of the thigh can be reduced with rapid diagnosis, careful preoperative planning, complete surgical resection by avoiding cyst rupture and concomitant anthelmintic chemotherapy.
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Affiliation(s)
- Nevzat Gonder
- Department of Orthopaedics and Traumatology, T.C. Ministry of Health Islahiye State Hospital, Gaziantep, 27800, Turkey.
| | - Ibrahım Halil Demir
- Department of Orthopaedics and Traumatology, Gaziantep University Hospital and Faculty of Medicine, Gaziantep, Turkey.
| | - Volkan Kılıncoglu
- Department of Orthopaedics and Traumatology, Gaziantep University Hospital and Faculty of Medicine, Gaziantep, Turkey.
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12
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Oğur HU, Kapukaya R, Külahçı Ö, Yılmaz C, Yüce K, Tuhanioğlu Ü. Evaluation of radiologic diagnostic criteria and treatment options in skeletal muscle hydatid cysts. J Orthop Surg (Hong Kong) 2020; 27:2309499019881219. [PMID: 31684830 DOI: 10.1177/2309499019881219] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
AIM To investigate the diagnosis and treatment methods of soft tissue involvement of hydatid cysts (HCs). MATERIALS AND METHODS Eleven patients who were diagnosed as having HC with muscular tissue (soft tissue) involvement between 2010 and 2016 were evaluated retrospectively. Seven patients had typical HC magnetic resonance imaging (MRI) and four patients had cysts with an unusual appearance. We evaluated how to diagnose the cysts using imaging methods, their characteristic radiologic images, and treatment alternatives against the disease. The patients were treated with antihelminthic chemotherapy preoperatively and postoperatively. RESULTS Of the 11 patients who underwent treatment, 7 were diagnosed using MRI and 4 were diagnosed with histopathologic examinations. The mean follow-up period was 16 (range, 6-24) months, and the mean age was 39.4 (range, 24-56) years. In seven patients, multivesicular appearance with specific MRI findings, T2-hypointense rim appearance, double-rim sign, membrane dissociation, and appearance of daughter cysts were identified as diagnostic criteria. Two patients underwent ultrasound assisted percutaneous aspiration-injection-reaspiration (PAIR) treatment. Seven patients underwent total pericystectomy, and two patients underwent subtotal pericystectomy with serum saline injection into the cyst. Two patients showed signs of mild anaphylaxis, one during the diagnosis and one during treatment. CONCLUSION There may be difficulties in the diagnosis and treatment of HCs of the musculoskeletal system. It should be known that there are alternative methods in the treatment (cyst excision and PAIR treatment). Clinical, serologic, and radiologic findings should be used in the diagnosis. To avoid complications during the histopathologic diagnosis, MRI should be examined in detail. It is thought that atypical cysts can be diagnosed (double-layer appearance and peripheral rim sign) in addition to typical cysts (detached membrane and multivesicular appearance), and diagnosis and treatment can be planned without anaphylactic complications.
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Affiliation(s)
- Hasan U Oğur
- Department of Orthopaedics and Traumatology, University of Health Science, Adana City Hospital, Adana, Turkey
| | - Rana Kapukaya
- Department of Plastic and Reconstructive Surgery, University of Health Science, Adana City Hospital, Adana, Turkey
| | - Özgür Külahçı
- Department of Pathology, University of Health Science, Adana City Hospital, Adana, Turkey
| | - Cengiz Yılmaz
- Department of Radiology, University of Health Science, Adana City Hospital, Adana, Turkey
| | - Kemal Yüce
- Department of Orthopaedics and Traumatology, University of Health Science, Adana City Hospital, Adana, Turkey
| | - Ümit Tuhanioğlu
- Department of Orthopaedics and Traumatology, University of Health Science, Adana City Hospital, Adana, Turkey
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Primary Giant Hydatid Cyst of Lumbar Paraspinal Muscles. World Neurosurg 2020; 141:240-244. [PMID: 32540285 DOI: 10.1016/j.wneu.2020.06.061] [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: 04/04/2020] [Revised: 06/05/2020] [Accepted: 06/07/2020] [Indexed: 11/21/2022]
Abstract
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.
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14
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Abstract
A hydatid cyst is a zoonotic disease caused by the worm Echinococcus granulosus. In endemic regions, it is a well-known differential diagnosis of cystic lesions, especially in the liver, lungs, brain, and vertebral column. Primary paravertebral muscle involvement, however, is rarely reported. In the current report, we present the case of an 11-year-old girl complaining of back pain with a well-defined single cystic lesion in her lumbar paravertebral multifidus muscle evident in imaging studies. The patient had no concomitant lesion in her systemic evaluation. The cyst was resected totally with its daughter cysts, and the pathology confirmed the diagnosis of a hydatid cyst. Although the paravertebral muscle is an extremely rare site of infection for a hydatid cyst, it should be kept in mind in mass lesions with a cystic nature.
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Affiliation(s)
- Homa Sadeghian
- Surgery, University of Pittsburg Medical Center Pinnacle, Harrisburg, USA
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15
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Kumar N, Garg R, Namdeo R. Primary pelvic hydatid cyst: A rare case presenting with obstructive uropathy. Int J Surg Case Rep 2018; 53:277-280. [PMID: 30447550 PMCID: PMC6240708 DOI: 10.1016/j.ijscr.2018.09.044] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2018] [Revised: 09/08/2018] [Accepted: 09/27/2018] [Indexed: 12/28/2022] Open
Abstract
Primary pelvic hydatid cysts are uncommon, usually presenting with pressure effects on the adjacent organs such as the urinary bladder and rectum. Combination of preoperative albendazole therapy, surgery and postoperative albendazole therapy is a useful regime. Familiarity with atypical manifestations of hydatid disease may be helpful in making a prompt and accurate diagnosis.
Introduction Hydatid disease is caused by infection with larva of the cestode echinococcus. Humans are accidental intermediate hosts. Primary pelvic hydatid cyst is a rare entity. Presentation of case This is a case report of a 50 year old gentleman who presented to us as a case of suprapubic swelling and difficulty in micturition. General physical examination and radiological evaluation confirmed a multiloculated pelvic swelling. Patient was subjected to laparotomy which confirmed the diagnosis of a primary pelvic hydatid disease. Discussion Surgery is the optimal treatment of the pelvic hydatid disease. Radical resectional procedure or en bloc resection that removes the entire pericyst is the surgical technique of choice. Conclusion Familiarity with atypical manifestations of hydatid disease may be helpful in making a prompt and accurate diagnosis. Surgery is the treatment of choice.
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Affiliation(s)
- Neeraj Kumar
- Dept. of General Surgery, VMMC & SJH, New Delhi, India.
| | - Raghav Garg
- Dept. of General Surgery, VMMC & SJH, New Delhi, India.
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Salman F, Khan MI, Hussain I, Abdullah HMA. Pathological fracture of femoral neck in a middle-aged woman: a rare presentation of primary hydatid cyst disease in humans. BMJ Case Rep 2018; 2018:bcr-2017-222980. [PMID: 29437772 DOI: 10.1136/bcr-2017-222980] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Hydatid disease in humans is caused by Echinococcus granulosus. It most commonly involves the liver and, to a lesser extent, the lungs and spleen; however, it is known to involve other areas, too. Involvement of bone by hydatid cyst is rare. Here, we describe the case of a 37-year-old woman who presented with pain in the left groin and swelling in the left thigh. The radiological imaging showed a fracture of the femoral neck and cysts in the shaft of the femur. Diagnosis of hydatid cyst was confirmed on the basis of histopathology of biopsy specimens. The patient recovered after surgical excision of the cyst. This case illustrates the various sites and presentations of hydatid cyst disease, and the need to investigate for it if cystic bony lesions are encountered especially in endemic regions, as a delay in diagnosis can lead to long-term morbidity and even death.
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Affiliation(s)
- Fnu Salman
- Department of Internal Medicine, Khyber Teaching Hospital, Peshawar, Pakistan
| | | | - Ishtiaq Hussain
- Department of Internal Medicine, Mardan Medical Complex, Mardan, Pakistan
| | - Hafez Mohammad Ammar Abdullah
- Department of Internal Medicine, University of South Dakota Sanford School of Medicine, Sioux Falls, South Dakota, USA
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17
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Gautam D, Malhotra R, Dubey S. Combination drug chemotherapy and massive skeletal allograft in the management of hydatid disease of femur. BMJ Case Rep 2018; 2018:bcr-2017-223332. [PMID: 29367378 DOI: 10.1136/bcr-2017-223332] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Hydatid disease of long bone is a rare presentation. Chemotherapy and surgery constitute the standard treatment of choice. Non-union of a pathological fracture of femur particularly due to hydatid disease has been known to be resistant to treatment. These resistant cases require combination drug chemotherapy and excision of the lesion. Reconstruction of a large skeletal defect following resection of the lesion poses a challenge to the orthopaedic surgeons. We discuss the staged treatment of hydatid disease of shaft of femur with resection and cement spacer application followed by reconstruction using massive skeletal allograft under cover of combination drug chemotherapy.
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Affiliation(s)
- Deepak Gautam
- Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Rajesh Malhotra
- Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Siddharth Dubey
- Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, Delhi, India
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Marzouki A, Naam A, Abdulrazak S, Soumaré B, Lahrach K, Boutayeb F. Musculoskeletal Echinococcus infection as a rare first presentation of hydatid disease: case report. Patient Saf Surg 2017; 11:21. [PMID: 28725269 PMCID: PMC5513117 DOI: 10.1186/s13037-017-0136-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Accepted: 07/12/2017] [Indexed: 12/20/2022] Open
Abstract
Background Hydatid disease (HD) is a cosmopolitan parasitosis caused by Echinococcus granulosus that can potentially affect any part of the human body. Liver and lungs are the most frequent localizations. Primary musculoskeletal hydatidosis are seldom reported in literature and their incidence is unknown. Case presentation We deem interesting to report a case of a primary hydatid cyst in a 25-year-old patient who presented with a painful swelling of the right elbow. Meticulous examination and preoperative imaging did not reveal other localizations. Patient was admitted for surgery where total excision of cyst was done without intraoperative spillage and a cutaneous skin flap was subsequently required to make up for soft tissue loss. Conclusion Primary hydatid cysts are sometimes difficult to diagnose preoperatively. It should be considered in the differential diagnosis of subcutaneous cystic lesions in regions where hydatid cysts are endemic. Currently, surgical excision is deemed first choice treatment for solitary cysts and antihelminthic treatment should be initiated preoperatively in the case of risk of rupture or in the event of complications.
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Affiliation(s)
- A Marzouki
- Department of Trauma and Orthopedic Surgery A Hassan II Teaching Hospital, Faculty of Medicine and Pharmacy Sidi Mohammed Ben Abdellah University, Fes, Morocco
| | - A Naam
- Department of Trauma and Orthopedic Surgery A Hassan II Teaching Hospital, Faculty of Medicine and Pharmacy Sidi Mohammed Ben Abdellah University, Fes, Morocco
| | - S Abdulrazak
- CHU Hassan II, Faculté de Médicine et de Pharmacie, Université Sidi Mohammed Ben Abdellah, Centre Hospitalier Hrazem, BP : 1835 Atlas, Avenue Hassan II, Fès, Morocco
| | - B Soumaré
- Department of Trauma and Orthopedic Surgery A Hassan II Teaching Hospital, Faculty of Medicine and Pharmacy Sidi Mohammed Ben Abdellah University, Fes, Morocco
| | - K Lahrach
- Department of Trauma and Orthopedic Surgery A Hassan II Teaching Hospital, Faculty of Medicine and Pharmacy Sidi Mohammed Ben Abdellah University, Fes, Morocco
| | - F Boutayeb
- Department of Trauma and Orthopedic Surgery A Hassan II Teaching Hospital, Faculty of Medicine and Pharmacy Sidi Mohammed Ben Abdellah University, Fes, Morocco
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Abstract
Because hydatidosis of the bone (echinococcus infection) is a rare parasitic infection, its diagnosis and treatment poses great difficulties. Radiologic imaging findings are generally helpful to make the diagnosis. But occurrence of disease in atypical places and lack of specific radiological findings may complicate differential diagnosis. Nevertheless, familiarity with imaging findings in patients living at endemic areas provides advantages for diagnosis and treatment.We present a cyst hydatic case in scaphoid bone which has been reported in the literature only once previously.
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Affiliation(s)
- Sancar Serbest
- From the Faculty of Medicine, Department of Orthopedics and Traumatology, Kırıkkale University, Kırıkkale (SS, UT) and Faculty of Medicine, Department of Orthopedics and Traumatology, Adıyaman University, Adıyaman (AU), Turkey
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Muscolo DL, Zaidenberg EE, Farfalli GL, Aponte-Tinao LA, Ayerza MA. Use of Massive Allografts to Manage Hydatid Bone Disease of the Femur. Orthopedics 2015; 38:e943-6. [PMID: 26488793 DOI: 10.3928/01477447-20151002-92] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2014] [Accepted: 02/23/2015] [Indexed: 02/03/2023]
Abstract
Hydatid disease is caused by the parasitic tapeworm Echinococcus granulosus. Osseous involvement accounts for 0.5% to 4% of cases in humans. Patients usually are from endemic zones and are initially asymptomatic, presenting with pain and edema at a later stage of disease. However, large lesions may present initially as pathologic fractures. Standard radiographs usually show expansive osteolytic lesions associated with initial cortical thinning, with compromise of the metaphysis or epiphysis, and may involve the diaphysis. The finding of periosteal reaction, osteocondensation, calcification, and clear delimitation of the lesions excludes the diagnosis of osseous hydatidosis. However, there are no specific radiographic signs in the affected bone. There is no generally accepted treatment algorithm for osseous hydatid disease. The usual treatment is surgical resection of the affected bone, followed by antihelmintic therapy. Some patients can be treated with intralesional procedures, such as curettage and allograft or polymethyl methacrylate cement. However, in some advanced cases, such as those with pathologic fractures or recurrences, wide resection may be needed. Several reconstructive alternatives have been reported, such as megaprosthesis, massive allograft, or alloprosthesis composite. The authors retrospectively reviewed 2 cases of femoral hydatidosis treated with wide resection and reconstruction with massive bone allograft. One patient had 5 years of follow-up, and the other had 9 years. No signs of relapse or complications were recorded, and functional outcomes evaluated with the Musculoskeletal Tumor Society scale showed excellent results. These 2 cases support the use of a massive bone allograft as a valid alternative to reconstruction after extensive bone resection for hydatidic disease.
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21
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Treatment of Bifocal Cyst Hydatid Involvement in Right Femur with Teicoplanin Added Bone Cement and Albendazole. Case Rep Orthop 2015; 2015:824824. [PMID: 26236523 PMCID: PMC4506908 DOI: 10.1155/2015/824824] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2015] [Revised: 06/18/2015] [Accepted: 06/21/2015] [Indexed: 11/17/2022] Open
Abstract
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.
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22
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Khan MS, Hashmi PM, Khan D. Eradication of advanced pelvic hydatid bone disease after limb salvage surgery - 5-year follow-up: a case report. J Med Case Rep 2015; 9:21. [PMID: 26187499 PMCID: PMC4506416 DOI: 10.1186/1752-1947-9-21] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2014] [Accepted: 12/10/2014] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Echinococcosis is produced by the larval stage of Echinococcus granulosus; it is a parasitic disease which is seen rarely in humans and has adverse outcomes. We report a case of advanced pelvic hydatid bone disease with successful limb salvage surgery. Our patient had a 5-year follow-up without recurrence which is a rarity as per the literature. Early diagnosis and prompt medical therapy are necessary for effective management whereas delayed diagnosis is always fraught with the risk of recurrence and sepsis. CASE PRESENTATION In 2009, a 30-year-old woman, native of Karachi (Sindhi ethnicity), presented at our clinic with history of a pathological fracture 11 years earlier. Her fracture was initially misdiagnosed and fixed. Subsequently she had persistent disease that progressed with time. Following this she underwent multiple surgeries and the diagnosis of hydatid disease was made but despite multiple debridements and medical therapy she was not cured and finally she was offered a hemipelvectomy (limb sacrifice). On presentation to our hospital she was counseled regarding options of hemipelvectomy versus a limb salvage form of modified internal hemipelvectomy and wide margin resection. She opted for limb salvage. She underwent internal hemipelvectomy with wide margin resection of soft tissue and proximal femur along with postoperative albendazole therapy. She was able to walk again after a very long period. Currently she is 5-years postreconstructive surgery. She is infection free and ambulant without support. CONCLUSIONS Hydatid bone disease is a rare entity in our part of the world but a careful history and thorough look at the initial images of our patient would have led to the suspicion of pathologic fracture and subsequent early diagnosis of this difficult problem. A second important learning point in this case was the lack of early referral to a center where this difficult problem could have been handled effectively. This could have minimized the physical, mental and financial stress to the patient and her family.
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Affiliation(s)
- Muhammad Shahid Khan
- Department of Orthopaedics, Shah Bhitai District Government Hospital, Hyderabad, Pakistan.
| | - Pervaiz Mehmood Hashmi
- Head Section of Orthopaedics, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan.
| | - Dawar Khan
- Department of Radiology, Aga Khan University Hospital, Karachi, Pakistan.
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Çiçekli Ö, Akgül T. An unusual cause of mass localized on vastus lateralis muscle in childhood: Hydatid cyst. Int J Surg Case Rep 2014; 6C:179-81. [PMID: 25544487 PMCID: PMC4334633 DOI: 10.1016/j.ijscr.2014.09.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Revised: 09/21/2014] [Accepted: 09/23/2014] [Indexed: 11/16/2022] Open
Abstract
Musculoskeletal hydatid cyst is usually associated with involvement of other solid organs. Echinococcus can mimic a tumor as mass in the muscle. The muscle is considered an unfavorable site for hydatidosis. Hydatid cyst should be kept in mind when observing soft tissue mass of the extremities in patients from areas endemic of Echinococcus granulosus.
Introduction Musculoskeletal hydatid disease is a rare pathology and its diagnosis is often delayed because of slowly growing mass without inflammation. It is critical to suspicious clinical diagnosis in rural endemic areas and for preoperative diagnosis of this disease. Presentation of case We present a 9-year-old boy referred with mass located on the anterolateral part of distal thigh. Diagnosis was verified with MRI histopathologically for the presence of hydatid cyst located in vastus lateralis muscle. Magnetic resonance imaging (MRI) was performed for further imaging. MRI showed an oval cystic mass approximately 77 × 20 × 18 mm in the left vastus lateralis muscle, containing round-shaped daughter cysts. Patients were treated with surgical excision and medical therapy. Clinical, radiological and serologic tests showed no recurrence after treatment. Discussion The muscle is considered an unfavorable site for hydatidosis because of its high lactic acid level that creates an unfavorable milieu for growth. The detachment of the germinative membrane from pericyst (water–lily sign) is considered to be pathognomonic and is reported in locations other than the liver and lung in magnetic resonance imaging. Surgery is the most effective way to treat hydatid cysts. Complete surgical resection and medical therapy are the preferred treatment for isolated echinococcosis. Conclusion Hydatid cyst in vastus lateralis is a very rare disease. Hydatid cyst should be kept in mind when observing soft tissue mass of the extremities in patients from areas endemic of Echinococcus granulosus.
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Affiliation(s)
- Özgür Çiçekli
- Şanlıurfa Training Hospital, Department of Orthopaedics, Turkey.
| | - Turgut Akgül
- Istanbul Faculty of Medicine, Department of Orthopaedics and Traumatology, Turkey.
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24
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Akcam AT, Ulku A, Koltas IS, Izol V, Bicer OS, Kilicbagir E, Sakman G, Poyrazoglu H, Erman T, Aridogan IA, Parsak CK, Inal M, Iskit S. Clinical characterization of unusual cystic echinococcosis in southern part of Turkey. Ann Saudi Med 2014; 34:508-16. [PMID: 25971825 PMCID: PMC6074578 DOI: 10.5144/0256-4947.2014.508] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The incidence of primary extrahepatic cystic echinococcosis (CE) is rare. Generally, radiological and serological findings can help establish the diagnosis of hepatic and pulmonary CE, but a CE in an unusual location with atypical radiological findings may complicate the differential diagnosis. The objective of this study is to present the characteristics of cases with extrahepatic CE in respect of sites of involvement, clinical presentations, radiological findings, serological diagnostic evaluations, and outcomes of infected patients. DESIGN AND SETTINGS A retrospective analysis of surgically treated CE was conducted between January 1993 and January 2014 in the General Surgery, Pediatric Surgery, Urology, Cardiovascular Surgery, Neurosurgery, and Orthopedics departments of University of Cukurova, Faculty of Medicine, Balcal Hospital. PATIENTS AND METHODS Among the 661 patients managed for CE, 134 had unusual sites of involvement. Radiological and serological examinations were used to differentiate CE from alveolar echinococcosis. RESULTS Of 134 cases with unusual sites of involvement, 32 cases had liver CE (23.9%), 7 cases had lung CE (5.2%), and 2 cases had concomitant liver and lung CE (1.5%). In 93 (69.4%) cases, unusual organ involvement was isolated without any liver or lung involvement. The mean age was 45 years. Abdominal pain was the main symptom and was found in 104 patients. Thirty-one (23.1%) of 134 extrahepatic CE cases were evaluated as negative with indirect hemagglutination (IHA). However, positive results were obtained in 54 cases evaluated with Echinococcus granulosus IgG Western blot (WB), including 10 IHA-negative cases. CONCLUSION CE with unusual localizations may cause serious problems of diagnostic confusion. The combination of clinical history, radiological findings, and serological test results (especially the WB) are valuable in diagnosing extrahepatic CE.
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Affiliation(s)
| | | | - Ismail Soner Koltas
- Ismail Soner Koltas, PhD, Department of Parasitology,, Cukurova University, Balcali,, Adana 01330, Turkey, T: +903223386060 F: +903223386572,
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25
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Mohammed S, Sawhney C, Biyani G, Shende P. Bone cyst: Case report and implications for the anaesthesiologist. Indian J Anaesth 2014; 58:767-8. [PMID: 25624550 PMCID: PMC4296371 DOI: 10.4103/0019-5049.147181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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26
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Aydin BK, Acar MA, Sumer S, Demir NA, Erkocak OF, Ural O. Primary hydatid disease of brachialis and biceps brachii muscles: a case report. Trop Doct 2013; 44:53-5. [PMID: 24226291 DOI: 10.1177/0049475513512636] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Primary hydatid cyst of the skeletal muscle is very rare and accounts for less than 1% of all cases. It is often asymptomatic and can pose diagnostic problems. Accurate diagnosis should be made using ultrasonography and magnetic resonance imaging. Proper treatment should be a wide surgical resection of the localized muscle with the aid of antihelmintic chemotherapy pre- and postoperatively. We report a case of primary hydatic cyst located simultaneously in both the biceps brachii and brachialis muscles, treated with wide resection surgery and pre- and postoperative anthelmintic chemotherapy.
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Affiliation(s)
- Bahattin Kerem Aydin
- Assistant Professor, Department of Orthopedics and Traumatology, Selcuk University, Faculty of Medicine, Konya, Turkey
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27
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Hui M, Tandon A, Prayaga AK, Patnaik S. Isolated musculoskeletal hydatid disease: diagnosis on fine needle aspiration and cell block. J Parasit Dis 2013; 39:332-5. [PMID: 26064030 DOI: 10.1007/s12639-013-0317-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2013] [Accepted: 05/18/2013] [Indexed: 10/26/2022] Open
Abstract
Hydatidosis is a zoonotic infection caused by Echinococcus granulosus. The most common sites of involvement are liver and lungs. Isolated musculoskeletal hydatidosis in absence of visceral involvement is rare and it mimics bone or soft tissue neoplasm. Fine needle aspiration cytology and cell block aids in diagnosis in such unusual location. Here we present one such rare case of isolated musculoskeletal hydatidosis diagnosed on fine needle aspiration cytology and cell block which was mimicking as fibrous dysplasia on radiology.
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Affiliation(s)
- Monalisa Hui
- Department of Pathology, Nizam's Institute of Medical Sciences (NIMS), Punjagutta, Hyderabad, India
| | - Ashwani Tandon
- Department of Pathology, Nizam's Institute of Medical Sciences (NIMS), Punjagutta, Hyderabad, India
| | - Aruna K Prayaga
- Department of Pathology, Nizam's Institute of Medical Sciences (NIMS), Punjagutta, Hyderabad, India
| | - Sujata Patnaik
- Department of Radiology, Nizam's Institute of Medical Sciences (NIMS), Punjagutta, Hyderabad, India
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28
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Leslé F, Magrino B, Dupouy-Camet J, Sailhan F. Two cases of femoral hydatidosis secondary to canine tapeworm treated by albendazole and prosthetic reconstruction. BMJ Case Rep 2013; 2013:bcr-2013-009497. [PMID: 23696145 DOI: 10.1136/bcr-2013-009497] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
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.
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Affiliation(s)
- Florence Leslé
- Department of Parasitology, Assistance Publique Hôpitaux de Paris, Paris, France
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29
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Abstract
Hydatid disease is a parasitic tapeworm infection caused by the Echinococcus species. Involvement of the long tubular bones is rare in hydatid bone disease. Patients are initially asymptomatic and usually present at a later stage of the disease when the bony lesions are extensive. Diagnosing bone hydatid disease is challenging, even in endemic regions, and a high index of suspicion is required because the radiologic findings often mimic other bone pathologies. Recurrence following treatment can occur after a long period of quiescence.This article describes a case of hydatid disease in a 62-year-old woman with extensive diaphyseal tibial involvement. She was treated with initial chemotherapy followed by extended curettage, polymethylmethacrylate cementation, and intramedullary fixation. Functional outcome was excellent, with no recurrence at 60-month follow-up. She was fully weight bearing with no pain or discomfort and had full hip, knee, and ankle range of motion.This case was important due to its rarity, the diagnostic challenge it presented, and the composite nature of the treatment used to avoid recurrence. Diaphyseal bone hydatidosis can be initially treated like a low-grade malignant tumor with curettage and high-speed burring, followed by filling the defect with polymethylmethacrylate cement. The composite treatment of chemotherapy with the surgical protocol described offers a reasonable chance of long-term disease suppression. Recurrent disease can be treated with repeat curettage and cementation. Wide excision with reconstruction of the resulting defect should only be considered for recalcitrant diaphyseal hydatid disease.
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Affiliation(s)
- Samik Banerjee
- Department of Trauma and Orthopaedics, Epson and St Helier University Hospital NHS Trust, Wrythe Ln, Carshalton, Surrey, SM5 1AA, UK.
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30
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Abdominal wall hydatid cyst: case report and review of literature. Case Rep Surg 2012; 2012:583294. [PMID: 22953153 PMCID: PMC3431058 DOI: 10.1155/2012/583294] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2012] [Accepted: 07/29/2012] [Indexed: 11/18/2022] Open
Abstract
A 60-year-old woman presented with a swelling in right paraumbilical region of one-year duration. Examination revealed a painless cystic swelling 15 × 10 cm with cough impulse. Ultrasound and CECT abdomen showed a subcutaneous cystic swelling with intramuscular extension. No other intraabdominal cystic lesions were found. Surgical exploration showed a cystic lesion adherent to peritoneum without any intraperitoneal extension. Cyst was carefully excised without any spillage. Gross specimen on opening showed multiple daughter cysts consistent with hydatid cyst, confirming the diagnosis of solitary abdominal wall hydatid cyst.
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31
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Mandal S, Mandal MD. Human cystic echinococcosis: epidemiologic, zoonotic, clinical, diagnostic and therapeutic aspects. ASIAN PAC J TROP MED 2012; 5:253-60. [PMID: 22449514 DOI: 10.1016/s1995-7645(12)60035-2] [Citation(s) in RCA: 104] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2011] [Revised: 01/15/2012] [Accepted: 03/15/2012] [Indexed: 12/13/2022] Open
Abstract
This review represents an updated scenario on the transmission cycle, epidemiology, clinical features and pathogenicity, diagnosis and treatment, and prevention and control measures of a cestode parasite Echincoccus granulosus (E. granulosus) infection causing cystic echinococcosis (CE) in humans. Human CE is a serious life-threatening neglected zoonotic disease that occurs in both developing and developed countries, and is recognized as a major public health problem. The life cycle of E. granulosus involves a definitive host (dogs and other canids) for the adult E. granulosus that resides in the intestine, and an intermediate host (sheep and other herbivores) for the tissue-invading metacestode (larval) stage. Humans are only incidentally infected; since the completion of the life cycle of E. granulosus depends on carnivores feeding on herbivores bearing hydatid cysts with viable protoscoleces, humans represent usually the dead end for the parasite. On ingestion of E. granulosus eggs, hydatid cysts are formed mostly in liver and lungs, and occasionally in other organs of human body, which are considered as uncommon sites of localization of hydatid cysts. The diagnosis of extrahepatic echinococcal disease is more accurate today because of the availability of new imaging techniques, and the current treatments include surgery and percutaneous drainage, and chemotherapy (albendazole and mebendazole). But, the wild animals that involve in sylvatic cycle may overlap and interact with the domestic sheep-dog cycle, and thus complicating the control efforts. The updated facts and phenomena regarding human and animal CE presented herein are due to the web search of SCI and non-SCI journals.
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Affiliation(s)
- Shyamapada Mandal
- Department of Zoology, Gurudas College, Narkeldanga, Kolkata-700 054, India.
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32
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Bulut M, Tosun HB, Simsek BC, Karakurt L. Primary hydatid cyst of the scaphoid: case report. J Hand Surg Am 2012; 37:1051-3. [PMID: 22480506 DOI: 10.1016/j.jhsa.2012.02.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2011] [Revised: 02/09/2012] [Accepted: 02/11/2012] [Indexed: 02/02/2023]
Abstract
Hydatid cyst caused by Echinococcus granulosus is a parasitic disease that can affect different organs. It is difficult to diagnose and has a tendency to recur. Primary bone involvement occurs in 0.5% to 4.0% of all patients with hydatid cysts. We present a 31-year-old woman with a primary hydatid cyst in the left scaphoid. Despite the availability of advanced imaging and laboratory investigation modalities (such as magnetic resonance imaging and serological studies) to make an adequate differential diagnosis of a cystic lesion in our case, intraoperative clinical suspicion led to the diagnosis. This was followed by a successful outcome without recurrence after 12 months.
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Affiliation(s)
- Mehmet Bulut
- Department of Orthopedics and Traumatology, Dicle University, Diyarbakir, Turkey.
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33
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Parasitic infections and myositis. Parasitol Res 2011; 110:1-18. [PMID: 21881948 DOI: 10.1007/s00436-011-2609-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2011] [Accepted: 08/04/2011] [Indexed: 12/20/2022]
Abstract
Infectious myositis may be caused by a wide variety of bacterial, fungal, viral, and parasitic agents. Parasitic myositis is most commonly a result of trichinosis, cystericercosis, or toxoplasmosis, but other parasites may be involved. A parasitic cause of myositis is suggested by history of residence or travel to endemic area and presence of eosinophilia. The diagnosis of parasitic myositis is suggested by the clinical picture and radiologic imaging, and the etiologic agent is confirmed by parasitologic, serologic, and molecular methods, together with histopathologic examination of tissue biopsies. Therapy is based on the clinical presentation and the underlying pathogen. Drug resistance should be put into consideration in different geographic areas, and it can be avoided through the proper use of anti-parasitic drugs.
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34
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Primary pelvic hydatid cyst: a case report. Case Rep Surg 2011; 2011:809387. [PMID: 22606594 PMCID: PMC3350145 DOI: 10.1155/2011/809387] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2011] [Accepted: 06/30/2011] [Indexed: 11/17/2022] Open
Abstract
This is a case report of a young man who presented to us as a case of hypogastric pain and frequency of micturation. General physical examination and radiological evaluation confirmed a multiloculated pelvic swelling. Patient was subjected to laparotomy which confirmed the diagnosis of a primary pelvic hydatid disease. Patient was put on chemotherapy after surgery and is doing well on follow up.
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Csotye J, Sisák K, Bardócz L, Tóth K. Pathological femoral neck fracture caused by an echinococcus cyst of the vastus lateralis--case report. BMC Infect Dis 2011; 11:103. [PMID: 21510859 PMCID: PMC3095994 DOI: 10.1186/1471-2334-11-103] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2010] [Accepted: 04/21/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Musculoskeletal hydatid cysts are rare, but being locally invasive, can potentially cause significant deformity or pathological fracture. CASE PRESENTATION A 39 y.o. male presented to our orthopaedic outpatient clinic complaining of severe right hip pain, and inability to ambulate. Symptoms were not preceded by trauma. Subsequent imaging confirmed a large, 17 × 3 × 5 cm echinococcus cyst in the vastus lateralis, causing erosion of the proximal metaphysis of the femur. As a consequence the patient suffered a non-traumatic pathological intertrochanteric femur fracture. The patient was treated with an en-bloc excision of the lesion - the affected soft tissue envelope containing the large cyst - and as a second surgical step a cemented total hip replacement (THR) was implanted under the same anaesthetic. The manuscript reviews the literature regarding musculoskeletal hydatid disease.
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Affiliation(s)
- János Csotye
- 1Department of Traumatology, Békés County Hospital, 1 Semmelweis Street, Gyula, 5700, Hungary
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Bansiwal RK, Sharma R, Attri AK. A large primary hydatid cyst of thigh: a case report. Indian J Surg 2011; 73:158-60. [PMID: 22468070 DOI: 10.1007/s12262-010-0205-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2009] [Accepted: 03/07/2009] [Indexed: 11/24/2022] Open
Abstract
Primary hydatid disease of musculoskletal system is rare. A 60 year old woman presented with soft swelling in medial aspect of thigh, of long duration which was gradually increasing in size. She was initially diagnosed as lipoma of thigh, but ultrasonography revealed to be a cystic swelling suggestive of hydatid disease. MRI further reinforced the diagnosis. However serologic test (ELISA) was negative. Patient was given albendazole preoperatively. The swelling was removed en bloc and advised for adjunctive albendazole chemotherapy (15 mg/kg/day) for three months.
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Sreeramulu PN, Krishnaprasad, Girish Gowda SL. Gluteal region musculoskeletal hydatid cyst: Case report and review of literature. Indian J Surg 2010; 72:302-5. [PMID: 23133278 DOI: 10.1007/s12262-010-0096-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2007] [Accepted: 01/07/2010] [Indexed: 12/14/2022] Open
Abstract
Hydatid disease is a parasitic infestation of humans and herbivorous animals, caused by Echinococcu granulosus. Dogs and some wild carnivores, like foxes, are definitive hosts, harboring worms in their intestines. Musculoskeletal cysts account for 0.7-3% of total cases of hydatidosis. Primarymuscular hydatidosis without involving the thoracic or abdominal organs is extremely rare. Intramuscular infestation may mimic a soft tissue tumor leading to inappropriate cyst rupture with the attendant risks of anaphylaxis and dissemination to other organs. So preoperative evaluation is critical to avoid lifethreatening complications. We report a case of 34-year-old male patient with a cystic gluteal swelling turning out to be hydatid cyst on surgical exploration. Surgical excision with a pharmacology complementary treatment with antihelementhics is necessary to achieve the complete healing.
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Affiliation(s)
- P N Sreeramulu
- Department of General Surgery, Sri Devaraj Urs Medical College, Kolar, Karnataka, India
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Recurrence of femoral echinococcosis 5 years after a primary surgical procedure. ORTHOPAEDICS & TRAUMATOLOGY, SURGERY & RESEARCH : OTSR 2010; 96:94-6. [PMID: 20170866 DOI: 10.1016/j.rcot.2009.12.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2008] [Accepted: 11/02/2009] [Indexed: 02/02/2023]
Abstract
We report a case of recurring femoral hydatid disease in a trisomic-21 patient 5 years after a primary surgery. The patient presented a thigh abscess with a lateral supracondylar area fistula. The workup demonstrated massive osteolysis involving the proximal, diaphyseal,and distal femur as well as multiple soft tissue cystic masses but no metastases. Treatment consisted in cystic masses debridment, extensive bony-curettage of the intraosseous cystic zones, temporary weight-bearing suppression, and albendazole. The patient remains under follow-up and cannot be considered definitely cured.
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Femoral allograft in the management of osseous hydatidosis presenting as femoral shaft non-union. Arch Orthop Trauma Surg 2009; 129:1627-32. [PMID: 19084977 DOI: 10.1007/s00402-008-0797-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2008] [Indexed: 12/21/2022]
Abstract
Osseous hydatidosis is a rare infection posing diagnostic and therapeutic challenge. We present a case of extensive hydatidosis of the femoral shaft with non-union of pathologic fracture. Patient had resection of involved femur and post-operative chemotherapy. Subsequently femur reconstruction was done using a femoral allograft. At 26 months patient has no recurrence and bony union is seen at host-allograft interface. We present this technique as an extended indication of allograft used in limb reconstruction.
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40
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Moretti B, Panella A, Moretti L, Garofalo R, Notarnicola A. Giant primary muscular hydatid cyst with a secondary bone localization. Int J Infect Dis 2009; 14 Suppl 3:e192-5. [PMID: 19889561 DOI: 10.1016/j.ijid.2009.07.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2009] [Revised: 06/26/2009] [Accepted: 07/08/2009] [Indexed: 12/30/2022] Open
Abstract
Primary musculoskeletal hydatidosis is less frequent than hydatidosis of the parenchymal organs. This localization has been little studied and so there is little information in the literature on the subsequent disease evolution. We present a case of primary hydatidosis of the abductor muscle that came to medical attention very late. After complete surgical removal of the huge mass, a secondary bone localization developed, causing a femoral pertrochanteric pathological fracture. The case described is exceptional in view of both the localization and the great size of the primary multi-lobed muscle hydatid cyst. We underline the difficulties of diagnosis and treatment of both the primary muscle localization and the secondary bone recurrence.
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Affiliation(s)
- Biagio Moretti
- Department of Clinical Methodology and Surgical Technique, Orthopedics Section, University of Bari, Piazza G. Cesare 11, Bari, Italy
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Bilgic S, Kose O, Sehirlioglu A, Safaz I, Ozkan H. Primary paraspinal hydatid cyst treated with puncture, aspiration, injection and re-aspiration (PAIR) technique: a case report. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2008; 18 Suppl 2:165-7. [PMID: 18696124 DOI: 10.1007/s00586-008-0737-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2007] [Accepted: 07/27/2008] [Indexed: 12/18/2022]
Abstract
Hydatid disease is a parasitic tapeworm infection that usually involves liver and lungs. Primary skeletal muscle hydatid cyst without liver and lung involvement is rare. En bloc resection without inducing rupture and spreading the daughter cyst is recommended treatment strategy and accepted to be curative for intramuscular hydatid cyst. We report a case of primary hydatid cyst of the erector spinae muscle which was treated successfully with ultrasonography guided puncture, aspiration, injection of 95% ethanol and re-aspiration (PAIR) technique.
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Affiliation(s)
- Serkan Bilgic
- Department of Orthopaedics and Traumatology, Gulhane Military Medical Academy, Etlik, Ankara, Turkey
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Abstract
Infectious myositis may be caused by a broad range of bacterial, fungal, parasitic, and viral agents. Infectious myositis is overall uncommon given the relative resistance of the musculature to infection. For example, inciting events, including trauma, surgery, or the presence of foreign bodies or devitalized tissue, are often present in cases of bacterial myositis. Bacterial causes are categorized by clinical presentation, anatomic location, and causative organisms into the categories of pyomyositis, psoas abscess, Staphylococcus aureus myositis, group A streptococcal necrotizing myositis, group B streptococcal myositis, clostridial gas gangrene, and nonclostridial myositis. Fungal myositis is rare and usually occurs among immunocompromised hosts. Parasitic myositis is most commonly a result of trichinosis or cystericercosis, but other protozoa or helminths may be involved. A parasitic cause of myositis is suggested by the travel history and presence of eosinophilia. Viruses may cause diffuse muscle involvement with clinical manifestations, such as benign acute myositis (most commonly due to influenza virus), pleurodynia (coxsackievirus B), acute rhabdomyolysis, or an immune-mediated polymyositis. The diagnosis of myositis is suggested by the clinical picture and radiologic imaging, and the etiologic agent is confirmed by microbiologic or serologic testing. Therapy is based on the clinical presentation and the underlying pathogen.
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Affiliation(s)
- Nancy F Crum-Cianflone
- Infectious Diseases Division, Naval Medical Center, San Diego, California 92134-1005, USA.
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Ozkan H, Dogramaci Y, Kose O, Esen E, Erdem H, Komurcu M. Primary Hydatid Disease of the Humerus. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2008. [DOI: 10.47102/annals-acadmedsg.v37n5p440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Affiliation(s)
- Hamdi Ozkan
- Ataturk Education and Research Hospital, Ankara, Turkey
| | | | - Ozkan Kose
- Gulhane Military Medical Academy, Ankara, Turkey
| | - Erdinc Esen
- Gazi University, Medical Faculty, Ankara, Turkey
| | - Hakan Erdem
- Ataturk Education and Research Hospital, Ankara, Turkey
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Primary hydatidosis of the gluteus muscles: report of three cases. Ir J Med Sci 2008; 178:359-62. [PMID: 18427874 DOI: 10.1007/s11845-008-0160-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2007] [Accepted: 04/08/2008] [Indexed: 10/22/2022]
Abstract
BACKGROUND Hydatid disease caused by the tapeworm Echinococcus granulosus is a worldwide problem especially in sheep and cattle raising countries. AIMS Muscle involvement is most commonly encountered as recurrence of previously treated disease or concurrently with primary lesions of the liver or lung. Furthermore, the rarity of muscle hydatidosis has unique implications in diagnosis and management. METHODS We report on three cases of primary echinococcus of the gluteus muscles presented in our clinic during a 10-year period. RESULTS We have administered albendazole for one cycle of 28 days in two of our patients based on the size and appearance of the cyst. All patients underwent total pericystectomy without cyst rupture. We have not found any recurrences after minimum follow up of 12 months. CONCLUSIONS Muscle echinococciasis respond well to surgical intervention. Complete and intact removal of the cyst in primary muscular hydatidosis should be considered curative.
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Kalacı A, Sevinç TT, Yanat AN. Sciatica of nondisc origin: hydatid cyst of the sciatic nerve. J Neurosurg Spine 2008; 8:394-7. [DOI: 10.3171/spi/2008/8/4/394] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
✓The authors report on an 81-year-old woman with a primary hydatid cyst located in the posteromedial aspect of the thigh. She presented with sciatica, and the cyst was also associated with neurological dysfunction because of its intra-neural location. Diagnosis of a cyst in a nerve body is very rare, and the one reported here might be the first such case. So far, in all the previously reported cases in which there were also neurological findings, the cysts in the vertebral column were compressing the spinal cord or there was an intrapelvic mass compressing the sciatic nerve. Hydatid cyst should be considered in the differential diagnosis of sciatica, especially when treating patients who live in or have emigrated from areas of the world whereEchinococcus granulosusis prevalent.
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Abd El Bagi M. Imaging of Parasitic Diseases of the Musculoskeletal System and Soft Tissues. IMAGING OF PARASITIC DISEASES 2007:159-177. [DOI: 10.1007/978-3-540-49354-9_7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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Alemdaroğlu KB, Iltar S, Pulat H, Atlihan D. Intermittent leg pain and swelling in a 30-year-old man. Clin Orthop Relat Res 2007; 462:248-54. [PMID: 17308475 DOI: 10.1097/blo.0b013e31803bbae7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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Mattern CJ, Gardner MJ, Grose A, Helfet DL. Case report: Echinococcus disease of the bone presenting as a femoral shaft nonunion. Clin Orthop Relat Res 2007; 458:220-5. [PMID: 17159572 DOI: 10.1097/blo.0b013e31802ff823] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
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.
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Affiliation(s)
- Christopher J Mattern
- Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY 10021, USA.
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Durakbasa MO, Kose O, Islam NC, Kilicoglu G. A primary hydatid cyst of the gracilis: a case report. J Orthop Surg (Hong Kong) 2007; 15:118-20. [PMID: 17429133 DOI: 10.1177/230949900701500127] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Primary hydatid disease of the skeletal muscle without systemic involvement is rare. A 40-year-old woman presented with a painful mass in her medial left upper thigh. She was misdiagnosed as having a deep intramuscular abscess and a fine needle aspiration was performed, but the fluid came out crystal clear. Further inquiry revealed that her 16-year-old daughter had been operated on twice for liver and lung hydatid disease. Thus, a provisional diagnosis of hydatid disease was made. An echinococcal haemagglutination test was positive. Ultrasonography and magnetic resonance imaging findings were consistent with a type-2 hydatid cyst showing a 'water-lily' sign. The cystic mass within the left gracilis was resected en bloc. Adjunctive albendazole chemotherapy (400 mg/day) was prescribed for 3 months. At the 22-month follow-up, the patient remained free of symptoms.
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Affiliation(s)
- M O Durakbasa
- Department of Orthopaedics and Traumatology, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey.
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