Aggressive hydatid disease of the foot and ankle

Abstract

An extremely rare case of aggressive hydatid disease of bone is described in a 29-year-old male. Although the disease was limited to the talus at initial presentation, it spread through the entire foot and ankle after surgical treatment. The unusual aggressive nature of the recurrence was attributed to the spread of infestation during the first surgery. Amputation of the foot and ankle was performed due to the invasive nature of the bone and soft tissue involvement.

CT findings in skeletal cystic echinococcosis

“…Cystic echinococcosis of bone is often asymptomatic for a long period and is usually detected only after a pathologic fracture, secondary infection or neurovascular symptoms caused by compression (1, 3, 6, 14, 15). In our cases, the most common clinical findings were pain, swelling, fracture, and symptoms caused by spinal cord or nerve root compression.…”

“…Cystic echinococcosis most commonly affects the liver (50–77%) and lung (8.5–43%), and the remainder, approximately 10–15% of the lesions, are spread throughout the rest of the body (10, 14). Skeletal cystic echinococcosis is rare and is found in only 0.5–2% of cases (1, 4, 10, 11, 14). Plain radiography, CT and MR imaging are helpful in the diagnosis of skeletal cystic echinococcosis (11, 15).…”

Imaging characteristics of three primary muscular hydatid cyst cases with various patterns

“…A low-intensity rim (rim sign), more evident on T2-weighted images, has been described as a characteristic sign in muscular HC; that is not a common fi nding in HCs located elsewhere in the body. [2][3][4][5][6] The differential diagnosis varies with the types of HCs. Differential diagnosis of the muscular HC includes abscesses, chronic hematomas, lymphangiomas, synovial cysts, and necrotic malignant soft tissue tumors.…”

“…2,6,9 The main clinical fi nding of muscular HCs is a palpable mass. 4 There are several classifi cations based on the radiological analysis of the morphology and the structure of the HC. They correspond to various developmental stages.…”

“…The reported soft tissue hydatid cysts are usually secondary and have a predilection for the lower limbs. 1,3,5 Primary hydatidosis of skeletal muscle is therefore rare, with reported prevalences of 0.5-4.7% [1][2][3][4][5][6][7] , because the cyst uses oxygen for growth and muscles usually contain lactic acids. 3,5 Soft tissue hydatid disease is unusual, even in endemic areas.…”