Breast Recurrent Hydatid Cyst Disease

Abstract

RezumatIntroducere: Chistul hidatic este o zoonoză întâlnită în zonele endemice. Aceasta reprezintă o reală problemă în ţara noastră, cu precădere în zona de est şi sud-est, reprezentată de Regiunea Anatolia. Invadarea de ţesut mamar izolat este foarte rară în boala hidatică. Din câte cunoaştem, hidatidoza izolată mamară recurentă nu a fost raportată până acum în literatură. Prezentare de caz: Scopul nostru este de a prezenta cazul unei paciente diagnosticată cu boală hidatică izolată mamară recurentă ipsilateral, prezentând o intervenţie chirurgicală pentru hidatidoză la nivelul glandei mamare drepte în urmă cu 9 ani. Concluzie: Boala hidatică trebuie luată în considerare în diagnosticul diferenţial al maselor mamare cu aspect chistic, în special în zonele endemice. Dacă pacienta a fost supusă în antecedente unei intervenţii chirurgicale pentru boală hidatică mamară, hidatidoza mamară recurentă trebuie luată în considerare la momentul diagnosticului diferenţial.

Isolated Primary Hydatid Disease of the Breast

“…The breast is an exceptionally unusual primary location for an isolated hydatid cyst and it makes up only about 0.27% of all cyst hydatidoses. [2][3][4][5] Upon examination, a smooth contoured circumscribed, movable mass is palpable not accompanying any regional lymphadenopathy as we witnessed in our case. Ultrasonography can show multiple cystic lesions with variable echogenicity and lobulated contours and can define it according to the Gharbi Classification.…”

“…5 FNAC of the cyst reveals segments of the laminated membrane consisting of parallel striations, scattered retractile hooklets, granular debris, and occasional multinucleated giant cells. 4,5 In our case, her mammography and ultrasound strongly suggested a cystic disease so we did not go for FNAC due to the fear of spillage. The gold standard management of isolated hydatid cyst disease of the breast is surgical excision.…”

“…Mammography shows ring-shaped structures inside the homogenous round, nonspecific mass and MR imaging might show capsular contrast enhancement. 4 Although FNAC is a constituent of the triple assessment of breast masses, some authors believe that it should not be done if the ultrasound indicates hydatid as a possible diagnosis. 2 However, some reports suggest fine-needle aspiration cytology as a reliable and risk-free procedure that can endorse conservative management.…”

“…5 Moreover, it has been established that chemoprophylaxis before and after the surgical excision with mebendazole helps minimize the relapse of cyst formation. 2,4 Relapse may occur in 2% to 25% cases due to either incompletely excised cysts or previously unidentified cysts. 5…”

Our clinical experience and follow-up results in hydatid cyst cases: a review of 393 patients from a single center

“…While the recurrence rates for hydatid disease vary between different series, some studies report a recurrence rate of 0.9%–22% in the 5 year follow-up. 21 , 22 In our study, 8.4% of our patients experienced recurrence during the mean postoperative follow-up of 40 ± 17 months. The recurrence rates in our study are similar to those in the literature.…”