Introduction:The thyroid localization of the hydatid cyst (HC) remains exceptional and unusual even in countries where this Parasitosis is still endemic: its frequency varies from 0.1 to 0.6 ‰ depending on the series. It is most often asymptomatic or resulting in anterior cervical swelling or more rarely a hoarseness of the voice. We report an original observation of thyroid HC revealed by primary hypothyroidism.Observation: An eight-year-old patient with no notable pathological history was explored for normochromic normocytic anemia at 8 g/dl. The clinical examination found neither jaundice nor splenomegaly. There was anterior cervical swelling that was painless and lateralized to the right. No lymphadenopathy or other palpable mass was noted. Biology revealed peripheral hypothyroidism with TSH at 7.83 μIU/ml. The balance of hereditary hemolytic anemias was negative. Cervical ultrasonography and CT showed an anechoic anterior cervical mass 2.51 cm in diameter, occupying the right thyroid lobe, without micro calcifications, intracystic vegetation, or adenopathies. Hydatid serodiagnostic was positive. The diagnosis of thyroid HC was confirmed by histological examination post loboishmectomy. The total blood count and TSH were spontaneously corrected after one month of the surgery.
Conclusion:The diagnosis of HC is worthy of mention in the presence of peripheral hypothyroidism with increased thyroid gland volume, especially in endemic areas. This location can sometimes hide associated thyroid neoplasia.
Introduction:The diagnosis of pains and masses of the right iliac fossa (RIF) represents a real diagnostic challenge for clinicians, particularly in the elderly, mainly because of the important clinical polymorphism at this age, and anatomical changes caused by senescence.We are reporting an original observation of an unexpected diagnosis of a RIF mass in the elderly.Case report: A 87-year-old Tunisian woman, without pathological medical history, was hospitalized in our department for exploration of a painful RIF mass evolving for two weeks. The somatic examination found a mass of the right iliac fossa, of hard consistency, tense, fixed in the deep plane, without fever or deterioration of the general state, or local cutaneous signs. The biology showed leukocytosis at 12 800/mm3 with 75% neutrophils, high erythrocyte sedimentation rate at 83mm/H1, and C-reactive protein at 22mg/l. Abdominal ultrasound and CT concluded at acute cholecystitis (AC). Surgery confirmed the diagnosis of acute gangrenous cholecystitis with significant dilatation of gallbladder that was prolapsed in the RIF.
Conclusion:As rare as it is, AC as possible etiology of RIF mass in elderly must be known to avoid diagnosis delay and improve the prognosis. To the best of our knowledge such a presentation was reported only once previously.
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