Primary infected hydatid cyst of the thigh in a young lady; case report with literature review

Abstract

Hydatid disease present in certain parts of the world. Infection of the musculoskeletal system occur in less than 0.5%.A 24-year-old lady had a painful mass in the inner aspect of the right thigh. MRI of the thigh showed a mixed signal intensity lesion measured about 65*100 mm, the mass was related to the muscle and the superficial femoral artery and its cavity had multiple septations.During surgery an infected hydatid cyst of the muscle was found, evacuation was done with removal of the cyst. The patient was discharged next day and she received anthelminthic medications for 3 months.Hydatid cyst of the muscles present with gradually enlarging mass or complications such as nerve compression, infection or rupture.Treatment may be medical using anthelminthic medications. Complete surgical excision is the best surgical option; involvement of other organs should be excluded. Follow-up is recommended.

An Iranian man with increased thigh mass due to a hydatid cyst

“…Hydatid cysts occur in the lungs and liver or other sites of body but primary CE in the muscle of thigh is rare and reported in the literature [ 2 ], [ 3 ], [ 5 ], [ 17 ]. Because of their rich vascular supply, neck muscles are the other muscular part of the body in which hydatid cysts have been found [ 33 ].…”

“…In the case report by Tahir et al [ 17 ], the patient had a painful mass on the inner aspect of right thigh. The MRI findings showed that the mass was related to the superficial femoral artery and the muscle.…”

“…This infection affects the liver and lungs in most cases (more than 90%), but all organs such as kidney, spleen, brain and other soft tissue can be affected [ 17 ]. CE rarely affects the musculoskeletal system.…”

“…On the other hand, one of the rarest systems to be affected by hydatid cyst is the musculoskeletal system (about 0.5–4%). Most of the time, it is an incidental finding in lung or liver, or by imaging studies in endemic regions [ 17 ]. However, based on our literature review, the occurrence of a thigh mass as the initial clinical presentation of hydatid cyst is very rare.…”

“…However, based on our literature review, the occurrence of a thigh mass as the initial clinical presentation of hydatid cyst is very rare. This is because the cysts have a high oxygen requirement in the tissue for growth, but muscles have a low oxygen content and are high in lactic acid, which inhibits the growth of cysts and muscle contraction [ 17 ], [ 21 ], [ 28 ], [ 29 ]. Of course, the proximal muscles of the lower limb have greater muscle mass and blood supply [ 30 ].…”