Hydatid Cyst of the Breast: A Case Series and Review of the Literature

Abstract

Introduction: A hydatid cyst of the breast is an extremely rare condition caused by Echinococcus granulosus, even in endemic countries, which accounts for 0.27% of all cases. Only a few reports have been published in the literature about breast hydatid cysts. Patients usually present with a palpable and painless lump in the breast. Clinically, it is difficult to differentiate breast hydatid cysts from more common breast lesions. However, imaging plays an important role, and often helps to distinguish this rare cystic disease of the breast from other breast masses. Case Presentation: Iran is an endemic area for Echinococcus granulosus, and we present six cases of primary breast hydatid cysts which were diagnosed over the course of 10 years in our institution. We aimed to present the mammographic and ultrasonographic findings for these patients. Conclusions: Hydatid cysts should be considered in the diagnosis of cystic lesions of the breast, particularly in endemic areas.

A case report of primary isolated extrahepatic hydatid cyst of the soft tissues of the breast and thigh

“…The ultrasonography of both cases showed a multiloculated cystic lesion with internal septa and echogenic material that was suggestive of HD. Similar findings of ultrasonography have been reported by Kumar et al, Tavakoli et al and Trabelsi et al [ 11 , 18 , 19 ]. MRI findings are non-specific, but may be helpful in the distinct identification of involved structures for surgical planning [ 17 ].…”

“…According to the endemicity of HD in Iran, these two cases were diagnosed having primary HD of the breast and muscle. The diagnosis of HD should be considered when a palpable, painless mass which gradually increases in size over months or years, in endemic areas [ 11 , 12 ]. It might mimic fibroademoma, phyllodes tumor, chronic abscess, or even malignancies, and this should be included in the differential diagnoses of breast lumps, especially in endemic regions [ 11 , 13 ].…”

“…The diagnosis of HD should be considered when a palpable, painless mass which gradually increases in size over months or years, in endemic areas [ 11 , 12 ]. It might mimic fibroademoma, phyllodes tumor, chronic abscess, or even malignancies, and this should be included in the differential diagnoses of breast lumps, especially in endemic regions [ 11 , 13 ]. The diagnosis of HD should be excluded before any surgical excision or biopsy or Fine needle aspiration cytology (FNAC), in order to avoid leakage of cyst components and accompanying risk of anaphylaxis and secondary hydatidosis.…”

“…The sensitivity of ultrasonography is 95% and if vesicular fibrils are present its sensitivity increases to 100% [ 16 , 17 ]. However, hydatid cysts are usually present as uniloculated or multiloculated cystic lesions in ultrasonography; but this modality does not easily distinguish hydatid cyst from other simple or complicated breast masses [ 11 ]. The ultrasonography of both cases showed a multiloculated cystic lesion with internal septa and echogenic material that was suggestive of HD.…”

Computer Tomography (CT) Characteristics of Pulmonary Cystic Echinococcosis

“…Liver involvement is accounted for 60-70% of organ involvement, followed by lung (25-30%), and other organs, such as brain and spinal cord, spleen, kidneys, heart, muscles, bones, endocrine and exocrine, eyes, genital organs, etc. (6), there is case reports of EC in organs such as breast (7), diaphragm (8), heart (9), ovary and fallopian tube (10) and multi-organ (11).…”