Primary hydatid disease in femoral muscles

Giant muscle hydatid in lower extremity: a rare case with neurological symptoms as the first manifestation

BACKGROUND

Human hydatid disease typically occurs in organs such as the liver and kidney. Primary solitary intramuscular hydatid disease, however, is rare.

CASE PRESENTATION

We report a case of a giant muscle hydatid in the lower extremity, with neurological symptoms as the first manifestation. The symptoms specifically manifested as intermittent pain in the right lower extremity and numbness in the sole of the right foot. However, there were no obvious abnormalities detected in electromyography and lumbar MRI. Subsequent ultrasonography and calf MRI showed that the patient had cystic lesions in the calf. The patient was initially diagnosed with a muscle hydatid cyst. Treatment involved complete surgical excision of the lesion, and the diagnosis of a hydatid cyst was confirmed through macroscopic and microscopic histopathological examination after the mass was excised. The patient was given oral albendazole, and no recurrence was observed during the 12 months of follow-up.

CONCLUSIONS

This case underscores the need to consider hydatid disease when diagnosing soft tissue masses in muscles, particularly in endemic areas. Patients may initially present with atypical symptoms like peripheral nerve issues.

Hydatid Cyst of the Thigh: A Report of a Rare Case With Literature Review

Hydatid cyst (HC) is a parasitic infection originating from the cestode of the Taeniidae family, predominantly occurring in the liver and lungs. Muscular involvement, however, remains a rarity. This report delineates the case of a 32-year-old female from Saudi Arabia presenting with a six-month history of an enlarging mass in her left thigh accompanied by significant localized pain. The clinical features were suggestive of an abscess, yet diagnostic imaging, specifically ultrasound, uncovered the presence of multiple daughter cysts within a primary lesion. MRI confirmed a well-defined encapsulated cystic mass. With an additional backdrop of a previously treated hepatic HC and living in proximity to a domestic cat, the clinical suspicion gravitated toward echinococcosis. Following surgical excision of the cystic lesion, histopathological examination confirmed the diagnosis of an infected HC. Postoperatively, the patient displayed an uneventful recovery with no recurrence or complications. This case underscores the diagnostic challenge posed by HC, especially in non-typical locations, and the pivotal role of imaging modalities in facilitating accurate diagnosis and subsequent management.

Primary hydatid cyst in the adductor muscles of thigh: A case report

Hydatidosis rarely (2%-3% of all cases) manifests as an intramuscular mass in endemic areas. This 55-year-old farmer with an asymptomatic thigh mass from 35 years ago presented with exertional pain in the last 40 days of the disease course. The patient started on albendazole and was cured with surgery.

Primary muscular hydadit cyst: Case report

Primary hydatid disease of the skeletal muscle without systemic involvement is rare. Since the infection appears on clinical examination to be a soft-tissue tumor. It is important to have a preoperative radiological evaluation, particularly with magnetic resonance imaging (MRI) to avoid biopsy or improper cyst management during surgery. We present a unique case of a primary hydatid cyst manifesting as an expanding soft-tissue mass in a 31-year-old woman's left thigh with magnetic resonance imaging revealed a very suggestive aspect of hydatid cyst in the adductor muscles and shows the interaction between cysts and nearby structures. The cyst was surgically removed, and macroscopic and microscopic histopathological examinations confirmed the diagnosis of muscular hydatidosis.

Primary giant hydatid cysts of the thigh and the gluteal region: a case report

Primary musculoskeletal echinococcosis is rare and accounts for 2-3% of the patients with hydatid disease. We report a case of giant primary hydatid cysts of the thigh and the gluteal region in an 82-year-old female, who presented with a painful multiple palpable mass. The diagnosis was confirmed by imaging and serology. Total resection was performed through an extended lateral approach of the thigh and intraoperative findings revealed infected giant hydatid cysts. The postoperative outcome was uneventful. Albendazole drug (400mg per day) was given for the next 3 months. At 6 months follow-up, the patient was satisfied with no complications or recurrence.

An arcane case report of primary intramuscular hydatid cyst of thigh

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Intramuscular hydatidosis is an extremely rare manifestation of hydatid disease which is endemic in India.

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Patient presented with a large swelling over the left thigh and was diagnosed in a timely manner using a multimodal approach.

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The rare location of the disease is confounding and required thorough and meticulous evaluation.

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Upon surgical exploration, the presence of multiple cysts and daughter cysts proved to be challenging but complete pericystectomy was achieved.

Introduction

Hydatid diseases are a cystic parasitic infestation caused by Echinococci which are endemic to parts of India and commonly occur in agricultural workers. Primary intramuscular hydatidosis is a rare manifestation of hydatid disease.

Presentation of case

Our case report describes a rare case of primary intramuscular hydatidosis in an agricultural worker with no involvement of any other viscera. This was diagnosed with clinical evaluation, radiological modalities and managed surgically.

Discussion

Hydatid disease is endemic in parts of India. Primary intramuscular hydatidosis is uncommon because the lactic acid in the muscle and muscle contractility hinders the development of cysts making it improbable diagnosis on first presentation. Hydatid cyst demonstrates a wide variety of imaging features, which can vary according to growth stage, associated complications and affected tissue. The treatment of choice is complete surgical excision of the cyst along with thorough irrigation of the surrounding soft tissues combined with the use of systemic antiparasitic drugs after surgery.

Conclusion

In a patient of an agricultural background of cattle rearing living in an endemic region and presenting with a swelling in the musculoskeletal system, a suspicion of hydatidosis should always be kept in the clinicians mind, so that it can be diagnosed using a multimodal approach and managed properly in a timely manner.

An Iranian man with increased thigh mass due to a hydatid cyst

Background: Hydatid cyst is a zoonotic infection caused by Echinococcosis granulosus. Primary single-intramuscular hydatid disease is rare, even in endemic regions of the world. Here we report the case of exceptional thigh mass due to a hydatid cyst in an Iranian man.

Case presentation: An 86-year-old man, initially presented to Velayat teaching hospital surgery clinic in May 2017 with a single right-thigh mass, but physical examinations of other organs were unremarkable. Based on sonographic findings, the differential diagnosis was hydatid cyst. He underwent surgical resection of the cyst. Histopathological results confirmed the diagnosis. There was no evidence of recurrence of the lesion during the 23-month follow-up.

Conclusion: Increase thigh mass due to a hydatid cyst is a rare event. In endemic regions with the presence of hydatid cysts, especially physicians of surgical clinics have to consider differential diagnosis of hydatid cysts in unusual locations in case of such a lesion.

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

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

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

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

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

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

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

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Infection is one of the common complications of hydatid cysts.

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

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

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Hydatid disease is endemic in certain parts of the globe.

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High index of suspicion is required for the diagnosis of this disease specially in rare anatomical sites like the calf.

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Involvement of other organs must be excluded as the disease may affects many organs simultaneously.

Background

Hydatid disease is a zoonotic disease that is transmitted to the human by ingesting the eggs of the parasite Echinococcus granulosus, it most commonly affects the liver but every organ could be affected, musculoskeletal system involvement occurs in 0.5–4% of patients. Most patients present as soft tissue mass in the affected muscle.

Preoperative diagnosis usually done radiologically by ultrasound or MRI examination.

Case presentation

We present a 60-year-old lady presented with painless mass in the right calf for 2 years.

The mass was soft, non-tender, mobile from side to side. Ultrasound of the mass showed cystic lesion that contained multiple small cysts inside, and the diagnosis of hydatid disease was made before surgery.

During surgery and after opening the mass the lesion appeared to be hydatid cyst containing innumerable daughter cysts. Complete evacuation of the all the daughter cysts done. The patient discharged next day with no postoperative complications.

The patient received postoperative albendazole therapy for 2 months and follow up done 6 months after surgery with no complications.

Conclusion

Hydatid disease should be thought when patients present with mass lesion in any part of the body especially in endemic areas. The most important step in the diagnosis is to exclude the presence of other cysts in other parts of the body.

Hydatid cyst of biceps brachii associated with peripheral neuropathy

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Hydatidosis represents the most significant parasitic disorder in the Mediterranean countries.

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Localization of the primary cyst hydatid infection in the extremity is rare.

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Primary musculoskeletal cyst hydatid generally affects the proximal muscle groups.

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Due to the fact that it leads to a mass formation, hydatid cysts may be mistaken for soft tissue tumors.

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MR is the golden standard of diagnosis and detection of multilocular polycystic lesions.

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Cases of concomitant neurologic findings and complaints secondary to peripheral nerve compression are very rare.

Introduction

Hydatidosis represents the most significant parasitic disorder in the Mediterranean countries and leads to major problems through unfavorable effects on the public health and national economy. Localization of the primary cyst hydatid infection in the extremity is rare and biceps brachii localization is also rarely reported in the literature.

Presentation of case

A 43-year-old woman, who presented with the complaints of mass and pain in the left arm and numbness of the hand. Laboratory investigations, X-ray and magnetic resonance (MRI) findings revealed hydatid cyst of the biceps brachi muscle. The mass was totally excised and the diagnosis was confirmed by the macroscopic images of the mass and the pathologic results. After the surgery, the patient had an improvement in the nerve compression findings including numbness of the hand and the upper extremity and pain.

Discussion

Localization of a primary cyst hydatid infection in the upper extremity is rare and there are no reports of peripheral neuropathy secondary to mass effect. Even if the pre-surgical electromyelography performed for the nerve conduction study reveals a normal result, the potential for the hydatid cysts to cause nerve compression should be taken into consideration in such patients.

Conclusion

Cases of concomitant neurologic findings and complaints secondary to peripheral nerve compression are very rare. The clinical findings should not be ruled out even if the EMG result is negative.

An unusual cause of mass in the shoulder: A primary hydatid cyst

A hydatid cyst is a zoonotic infection which may affect any organ and tissue, particularly the liver and the lung. Primary muscular hydatid cysts comprise less than 0.7-3% of the cases. The hydatid cysts must be kept in mind to avoid a diagnostic puncture in cystic lesions to avoid the spreading of the disease. In this case report, we present an exceptionally rare case with an unusual localization of a primary hydatid cyst in the left deltoid muscle.

Primary musculoskeletal hydatid cyst of the thigh: Diagnostic and curative challenge for an unusual localization

Primary muscular echinococcosis is an uncommon localization of hydatid cysts. The nonspecific clinical presentation and possible post-therapeutic complications lead to problems for the diagnosis of this infection and the support of the patient. The authors describe an unusual case of double hydatid cyst of the vastus intermedius muscle. After a precise preoperative evaluation based on clinical, radiological and biological examinations, a surgical excision by pericystectomy combined with perioperative chemotherapy enabled the authors to treat the patient and to prevent postoperative complications. The diagnostic tools and the treatment of this particular type of echinococcosis are discussed.

A rare case of femoral hydatidosis

BACKGROUND

We present a case of a hydatid cyst located in the left thigh.

CASE REPORT

A 67-year-old man was admitted to our department with a 10 × 5 × 4 cm mass in the medial compartment of the left thigh. Computed tomography scan indicated possible hydatidosis. Serological testing (indirect hemagglutination) was positive for hydatidosis. The patient was operated seven years ago for liver hydatidosis.

RESULTS

The patient, after evaluation, underwent surgical excision of the cyst under epidural anesthesia. The cyst was located in the left quadriceps muscle; had a soft, elastic substance; was firmly attached to the muscle fibers; and contained transparent fluid and daughter cysts. Histologic examination confirmed the initial diagnosis. The patient was discharged on the fifth postoperative day.

CONCLUSIONS

The diagnosis of muscular hydatidosis is difficult and the usual diagnostic methods are the serological tests for hydatidosis and imaging (e.g., ultrasound, computed tomography, and magnetic resonance imaging). In every soft tissue mass with benign characteristics the existence of a hydatid cyst should always be considered. Careful surgical excision of the intact cyst is the treatment of choice, but complementary control for liver-or other organ-hydatidosis should be performed.

Primary hydatid disease of the thigh. A rare location

Primary muscle hydatidosis is very rare, accounting for less than 1% of hydatid cyst locations. Clinical symptoms are insidious and non-specific causing a frequent delay in diagnosis. Intramuscular hydatid disease can cause a variety of diagnostic problems, especially in the absence of typical radiologic findings. We report the observation of an 82-year-old man consulting for inguinal tumefaction with radiological exploration suggestive of hydatid cyst of the adductors muscles. Magnetic resonance imaging (MRI) is helpful in diagnosis, since it reveals a very suggestive aspect and demonstrates the relationship between cysts and adjacent structures. Treatment of muscle echinococcosis is based on surgery, which is curative and incurs a low risk of local relapse.

Giant primary muscular hydatid cyst with a secondary bone localization

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.

Case report of a primary multiloculate muscular cystic hydatidosis

Hydatidosis is a zoonosis caused by the ingestion of Echinococcus granulosus eggs, released though the feces, from infected dogs to humans. Primary localization is mostly hepatic and/or pulmonary, whereas muscular involvement is very rare, even more so in muscular striated tissue. This is the report of a case of a primary intramuscular hydatid cyst in a 79-year-old woman who presented with a 3-year history of a painful lump in her proximal medial left thigh. The authors document the exceptional giant dimensions of the cyst, which have not previously been reported in a case of striated muscular hydatid disease.

Muscular cystic hydatidosis: case report

Background

Hydatidosis is a zoonosis caused by Echinococcus granulosus, and ingesting eggs released through the faeces from infected dogs infects humans. The location of the hydatid cysts is mostly hepatic and/or pulmonary, whereas musculoskeletal hydatidosis is very rare.

Case presentation

We report an unusual case of primary muscular hydatidosis in proximity of the big adductor in a young Sicilian man. The patient, 34 years old, was admitted to the Department of Infectious and Tropical Diseases for ultrasonographic detection, with successive confirmation by magnetic resonance imaging, of an ovular mass (13 × 8 cm) in the big adductor of the left thigh, cyst-like, and containing several small cystic formations. Serological tests for hydatidosis gave negative results. A second drawing of blood was done 10 days after the first one and showed an increase in the antibody titer for hydatidosis. The patient was submitted to surgical excision of the lesion with perioperatory prophylaxis with albendazole. The histopathological examination of the bioptic material was not diriment in the diagnosis, therefore further tests were performed: additional serological tests for hydatidosis for the evaluation of IgE and IgG serotype (Western Blot and REAST), and molecular analysis of the excised material. These more specific serological tests gave positive results for hydatidosis, and the sequencing of the polymerase chain reaction products from the cyst evidenced E. granulosus DNA, genotype G1. Any post-surgery complications was observed during 6 following months.

Conclusion

Cystic hydatidosis should always be considered in the differential diagnosis of any cystic mass, regardless of its location, also in epidemiological contests less suggestive of the disease. The diagnosis should be achieved by taking into consideration the clinical aspects, the epidemiology of the disease, the imaging and immunological tests but, as demonstrated in this case, without neglecting the numerous possibilities offered by new serological devices and modern day molecular biology techniques.