Pathological fracture of femoral neck in a middle-aged woman: a rare presentation of primary hydatid cyst disease in humans

Salman, Fnu; Khan, Muhammad Asim; Hussain, Ishtiaq; Abdullah, Hafez Mohammad Ammar

doi:10.1136/bcr-2017-222980

Cited by 7 publications

(10 citation statements)

References 33 publications

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“…Therefore, the clinical presentation is usually determined by the size of the cyst and the involved organ system. In a vast majority of cases, bone cysts are asymptomatic until a pathological fracture develops [8]. In cases of osseous hydatidosis of the pelvic bone, there is no specific set of symptoms.…”

Section: Discussionmentioning

confidence: 99%

Pelvic Bone Hydatidosis: A Dangerous Crippling Disease

Inayat

Rana

Shoaib

et al. 2019

Cureus

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Hydatid disease is one of the most complicated and devastating conditions caused by Echinococcus granulosus . This globally distributed disease continues to be an important public health concern in many low- and middle-income countries. The liver and the lungs are the most frequently involved sites, but virtually any organ system can be affected. Osseous hydatidosis is relatively less common, but it is extremely debilitating and difficult to manage due to frequent recurrences. Patients often demonstrate a delayed clinical presentation as bone involvement is predominantly a silent and slowly progressive disease with a long latent period. Radiological investigations play an important role in the diagnosis. Although standard therapeutic guidelines are not available, the treatment of choice is a combination of chemotherapy and surgery. Clinicians should perform a lifelong follow-up for early detection of potential recurrence and sequels. This paper aims to highlight hydatid disease of the pelvic bone as an important differential diagnosis of tubercular hip arthritis, especially in areas with high echinococcosis prevalence.

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Section: Discussionmentioning

confidence: 99%

Pelvic Bone Hydatidosis: A Dangerous Crippling Disease

Inayat

Rana

Shoaib

et al. 2019

Cureus

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“…The diagnosis of a hydatid cyst is mainly constructed around the patient's history, clinical findings, and examinations. The examinations consist of Serology test, Ultrasonography, with the best efficacy for detecting cysts as small as 1 cm [18,19], CT scan, with a sensitivity of 100% [20], and Histopathological study of biopsy [21,22]; however, performing biopsy can be dangerous, due to risk of the cyst rupture. Also, some parts of the cyst can get dislocated and migrate to other areas of the body and create secondary cysts [7].…”

Section: Discussionmentioning

confidence: 99%

“…Also, some parts of the cyst can get dislocated and migrate to other areas of the body and create secondary cysts [7]. Serology tests can help diagnose the disease and follow-up of the hydatidosis reoccurrence or new cyst formation in other parts of the body [22,23]. Preoperative diagnosis of cystic hydatidosis, especially in non-endemic areas and rare sites of cyst formation, is complex and can sometimes be misdiagnosed with an abscess [24,25] and dermoid cyst [9].…”

Section: Discussionmentioning

confidence: 99%

Perineal and right femoral hydatid cyst in a female with regional paresthesia: a rare case report

et al. 2022

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Background Hydatid cyst is a zoonotic disease caused by the parasite Echinococcus granulosus. The tapeworm larvae can create cyst in different areas of the body, especially the liver and lungs; however, the formation of the cyst in the perineal and femoral regions are very rare. The unusual location of the cyst can help us with the differential diagnosis of soft tissue mass(es) in this location, especially in endemic areas. Diagnosis of this disease is crucial because if the cysts are ruptured during surgery, the fluid inside can cause anaphylactic shock. Case presentation Our case is a 55-year-old woman with the chief complaint of a painful mass in the right thigh and perineal area with progressed pain and paresthesia to the right thigh and shin. The patient had no history of fever, abdominal pain, digestive dysfunctions, or chest pain. The vital signs were normal, and there was no family history. Physical examination showed that the skin over the mass had no discoloration, and the size was around 5.7 cm long. The result of the ultrasonography examination showed a cystic mass with suspicion toward the femoral hernia. After a CT scan, the result of secondary workups was a multi-lobular cystic mass with no connection to the abdominal region, which suggested a hydatid cyst. The patient underwent spinal anesthesia and surgery, a cystic mass with ecto- and endocyst, with clinical similarity to a hydatid cyst, was removed with wide margins, and the cyst wall was kept intact. In the next step, the specimen was sent for histological examination that confirmed cystic hydatidosis. The Post-surgical Abdominal and thoracic Ultrasonography screening were used to exclude relapse, and medical therapy was given for 3–6 months. An 18-months follow-up demonstrated no reoccurrence and no newly formed cyst. Conclusions Although rare, femoral hydatid cyst can occur in some cases, especially in endemic areas. We highly recommend our colleagues consider ruling out cystic hydatidosis in any patients complaining of regional mass(es), mostly painless, presenting with adjacent tissue compression with or without manifestation of an allergic reaction.

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“…Aneurysmal bone cyst, giant cell tumor, and bone tuberculosis can be considered as potential differential diagnoses in this case [3,11]. The most common of these underlying lesions is the giant cell tumor.…”

Section: Differential Diagnosismentioning

confidence: 94%

Evaluation of imaging features of pelvic echinococcosis based on multimodal images

Chen¹,

Aikebaier²,

Zhao³

2020

J Orthop Surg Res

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Background Hydatid disease (HD) is a zoonotic parasitic disease caused by the larvae of Echinococcus, It is mainly prevalent in pastoral areas. Bone echinococcosis is rare, accounting for 0.5 to 4.0% of all echinococcosis. It is likely to miss the diagnosis and misdiagnose due to non-specific early symptoms and the clinical manifestations and imaging features. The clinical data of 15 patients with pelvic cystic echinococcosis were analyzed retrospectively, and the X-ray, CT, and MRI imaging features of the disease were discussed, which are reported below. Methods All 15 patients underwent CT scan evaluation. A total of 8 patients underwent coronal, sagittal, and three-dimensional reconstruction with 3-mm-slice thickness, and 4 patients underwent X-ray plain film examination. Five cases underwent MRI scan. Eight cases underwent MRI or CT enhanced scan. Results X-ray plain film is characterized by continuous cystic bone destruction, irregular low-density shadow when invading soft tissue, and sometimes calcification which can be seen on the wall or inside the cyst. The involved sacroiliac joint or hip joint may narrow or disappear. The involvement of pelvic cystic echinococcosis is relatively wide, and 80% of patients with pelvic cysts in this group had multiple lesions in the same period. Cystic expansive bone destruction was the most common. Pelvic CT revealed a lobulated hypodense lesion of varying size with internal septae, causing cortical thinning and destruction. Most of them had no periosteal reaction. The iliopsoas muscle is most easily invaded. Single cystic echinococcosis of pelvis showed intermediate or low signal intensity on T1-weighted images and hyperintensity on T2-weighted images in the involved bone and surrounding soft tissue on MRI, and the cyst wall showed linear low signal in T1WI, T2WI, and STIR sequences. The polycystic type is characterized by multiple cysts of varying signal intensity (daughter cysts) within a larger cyst is the typical MRI finding, forming “small vesicles” high signal daughter cysts. Osteosclerosis or calcification showed low signal in T1WI and T2WI. Conclusions The results of this study suggest that the lesions of pelvic cystic echinococcosis are mostly cystic expansive and osteolytic bone destruction, which is easy to invade the surrounding soft tissue, often accompanied with calcification; among them, multiple cystic lesions are characteristic.

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Pathological fracture of femoral neck in a middle-aged woman: a rare presentation of primary hydatid cyst disease in humans

Cited by 7 publications

References 33 publications

Pelvic Bone Hydatidosis: A Dangerous Crippling Disease

Pelvic Bone Hydatidosis: A Dangerous Crippling Disease

Perineal and right femoral hydatid cyst in a female with regional paresthesia: a rare case report

Evaluation of imaging features of pelvic echinococcosis based on multimodal images

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