Triple communicating complicated hepatic hydatid cyst: an unusual presentation and laparoendoscopic management

Multi-sited hydatid cystic disease with muscular involvement in a young female: A case report from Syria

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Musculoskeletal involvement with hydatid cystic disease accounts for less than 5% of all cases.

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This low incidence is related to the filtering function of the liver and lungs.

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Surgery is the optimal treatment of hydatid disease.

Introduction

Hydatidosis is a unique disease caused by a tapeworm called Echinococcus granulosus. Musculoskeletal involvement with hydatid cystic disease accounts for less than 5% of all cases. The main purpose of this study is to present a case of multi-sited hydatid cystic disease and how to manage it.

Presentation of case

Here we present a case of 14-year-old girl complained of a gradually enlarging mass on her left shoulder with a final diagnosis of triple-sited hydatid cystic disease including the right lung, the left trapezius muscle and the liver.

Discussion

The diagnosis was made by non invasive radiological procedures (CT scan and MRI). The management consisted of aspiration and reinjection of hypertonic solution to the lung cyst followed by complete surgical resection, enucleation of the muscular lesion and conservative management of the liver lesion. After Three months of follow up there was no recurrence at the sites of operation and the liver cyst reduced in size.

Conclusion

Multi-sited hydatid cysts could be treated through one stage surgery followed by chemotherapy with benzimidazoles.