A rare primary hydatid cyst of the psoas muscle in a rural setting: A case presentation

Abstract

Hydatid cyst is a zoonosis caused mainly by the larval stage of the cestode worm Echinococcus granulosus, hydatidosis is frequently found in sheep-raising countries such as the Mediterranean countries. The disease usually involves the liver (75%) and lung (15%). We describe a case of hydatid cyst of the psoas muscle; we are reporting this case because of its rarity and its difficulty to diagnose clinically. A 16 –year-old female from rural setting, presented to the department of surgery of our institution, with complaints of right flank pain. On abdominal examination, there was sensitization in the right lower quadrant, and there was no resistance or rebound. On abdominal ultrasonography, a 6 × 6 cm hydatid cyst was detected within the psoas muscle, which was confirmed by positive indirect hemagglutination, no other organ involvement has been detected by CT scan. A pericystectomy was performed; the intact intramuscular cyst was completely excised, Macroscopic and microscopic examination of the specimen confirmed Hydatid cyst. The patient was discharged from hospital on the fifth postoperative day. No local recurrence was detected during postoperative follow up. Hydatidosis should be considered in cases of a symptomatic swelling in musculoskeletal system without history of trauma and irradiation when patients belong to endemic area. Cyst or complex retroperitoneal tumors, cold or pyogenic abscess of psoas muscle are considered in differential diagnosis. In the light of this case and the literature data, we discuss the diagnosis and the therapeutic problems raised by hydatid cyst of the psoas muscle.

Two hydatid cysts in the psoas muscle of a 40-year-old female: A rare case report from Syria

“…The e cient ltration mechanisms of the liver and lungs make it challenging for echinococcal larvae to reach musculoskeletal tissues. Additionally, the high lactic acid content and mechanical factors in muscles deter parasite growth [1,2]. Psoas muscle hydatid cysts typically manifest during childhood and young adulthood as painless muscle masses.…”

“…The greatest danger for the patient (especially if hydatid disease is not suspected preoperatively) is dissemination with possible secondary implant and anaphylactic reaction. It is obvious that every measure must be taken to avoid dissemination of the disease [2,4]. The use of supplementary chemotherapy with anti-helminthic drugs for skeletal muscle hydatid disease remains controversial, lacking evidence-based recommendations [7].…”

“…Clinical symptoms can vary from nonspeci c complaints to severe complications like anaphylaxis and death. Complications of psoas muscle hydatid cysts may include superinfection, nerve injuries, ureteral compression, and other serious consequences [2]. Imaging plays a crucial role in diagnosing and assessing hydatid disease.…”

The Effect of Preoperative Albendazole Treatment on Intramus-cular Cyst Structure in a Patient with Simultaneous Cystic Echinococcusis of Liver and Vastus Lateralis Muscle

“…Some authors used longer courses (between 1–3 months) of preoperative albendazole treatment to decrease the viability of the cyst and the risk of recurrence ( 5 ). Besides, some authors immediately removed the cyst and applied postoperative chemotherapy to not to weaken the capsule of the cyst with preoperative albendazole treatment ( 6 ). Manouras et al evaluated the effect of preoperative 28-day albendazole treatment via MRI ( 7 ).…”

The Association of Antiphospholipid Syndrome Stimulated by Cytomegalovirus Infection with Pregnancy Outcome Among Women with Bad Obstetric History in Babil/ Iraq

“…A thyroglossal duct cyst may appear similar to other growths around the neck (e.g., epidermoid cyst, brachial cleft cyst, and bronchogenic cyst) [12,13].…”