A hydatid cyst in an unusual location—The infratemporal fossa

Abstract

Hydatid disease is a considerable health problem worldwide, but hydatid cysts in the infratemporal region are extremely rare, even where the parasite is endemic. Here we report on a 17-year-old female who presented with a benign swelling in the infratemporal fossa. During surgery a cystic mass was discovered and histopathologic examination confirmed the diagnosis of a hydatid cyst. Although rare, a hydatid cyst should be considered in a differential diagnosis of benign swellings in the maxillofacial region. Physicians should exercise a high index of suspicion even in nonendemic locations.

Hydatidosis of infratemporal fossa with proptosis – an unusual presentation: a case report and review of the literature

“…This case report describes a 65-year-old Gurung Nepalese woman with primary hydatid cyst of the infratemporal fossa. The uniqueness of this case is that our patient presented with unilateral ophthalmological signs and symptoms including proptosis due to the extension of the lesion into the orbit and the orbital bones unlike previously reported cases of hydatidosis of the infratemporal fossa where most of the patients presented with swelling of the maxillofacial region [ 6 , 14 , 16 , 17 ].…”

“…The life cycle of the E. granulosus involves a definitive host (dog and other canines) and an intermediate host (usually sheep, cattle, and goats) with humans as accidental hosts following the ingestion of the larvae. Once ingested, the larvae pass into the bloodstream through the intestinal mucosa, where they are most likely to infest the liver because this is the first organ that they pass through [ 6 ]. Once the larvae are distributed throughout the intermediate host’s body, they grow into a stage called hydatid cyst [ 7 ].…”

Primary hydatid cyst of the pterygomandibular region: an unusual cyst, location and case report

“…Sometimes these exit the pulmonary arterial capillaries to The symptoms of hydatid cysts mimic those of a benign, slow-growing tumor or cyst and vary based on the location and size of the cyst and degree of compression of the surrounding structures 5 . Even in hydatid cyst endemic areas, its occurrence in the head and region is rare, which facilitates the dismissal as a possible differential diagnosis in the head and neck region 6 . A fine needle aspiration is sufficient for diagnosis and should always be preferred over fine needle biopsy because of the tendency of the cystic content to cause anaphylactic reactions.…”

“…A mixture of 95% ethanol, 20% hypertonic saline, and 0.5% silver nitrate has been used as a scolicidal agent and is injected into the cyst before attempting removal 4 . The area around the cyst can also be protected from contamination with surgical pads soaked with a scolicidal agent 6 .…”

“…Injection of 20% hypertonic saline or 5% silver nitrate solution into the cyst can cause inactivation of the daughter cysts before surgery. Additional treatment with albendazole has been recommended by a few researchers to reduce the risk of contamination and to prevent recurrence 6 . Multiorgan involvement has been reported in 2% to 40% of cases and thus thorough examination and investigations are required to rule out additional lesions elsewhere in the body.…”