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.

Highlights Retrosternal goiter is defined when the thyroid gland extends below the thoracic inlet. It causes compression over the respiratory and the digestive passages, or pressure over the superior vena cava. It needs surgical treatment in most patients and usually requires the combined cervical and the thoracic approach.

Urinothorax is the presence of the urine in the pleural space. This condition is very rare and occurs due to unrelieved obstruction of urinary flow. A 20-year-old female presented 7 days after cesarean section with tachypnea, and generalized abdominal pain. There was absent air entry over the left hemithorax. CT scan showed massive left pleural effusion and a stone obstructing the renal pelvis with hydronephrosis and peri-renal collection. The pleural fluid had high fluid creatinine level suggesting urine collection. Ureteroscopy done and double J catheter inserted. The effusion became loculated, thoracotomy and pleural decortication done.

Hydatid cyst of the heart is very rare, the left ventricle is the commonest site of myocardial involvement due to dominant left coronary vessels and thicker wall. Isolated cardiac involvement is extremely rare. Patients may be quite asymptomatic but the cyst may cause palpitation, dyspnea, chest pain, or when ruptured in to the cardiac or pericardial cavities may cause emergency presentations like anaphylactic reactions, sudden collapse due to pericardial tamponade or even sudden death.A middle age female presented with exertional shortness of breath for 2 years. Echocardiography showed mitral valve stenosis. Computerized tomography scan of the chest showed a big complicated hydatid cyst arising from the wall of the right ventricle. Median sternotomy was done with excision of the hydatid cyst, and repair of mitral stenosis by commissurotomy. The patient received three cycles of albendazole for three months.Surgery is the best options of treatment of cardiac hydatid disease, when the disease is affecting the pericardium complete excision may be possible, but when the myocardium is involved it may be difficult or even impossible to do complete excision, in this situation the cyst contents should be evacuated completely, preventing spillage is very mandatary to prevent recurrence. Care must be taken to avoid damage to the conductive system, the papillary muscles, the aortic and the mitral valves. Medical treatment with anthelminthic medications is used after surgery to reduce the recurrence rate.