Primary Subcutaneous Hydatid Cyst Over Thoracic Spine: A Case Report and Review of the Literature

Abstract

Hydatid disease is a public health problem in endemic areas. Although it is most commonly present in the liver and lung, it rarely affects other tissues. A 62-year-old female patient was admitted to our outpatient clinic with a palpable, moderately mobile mass over the thoracic spine. On MRI, a cystic lesion, hypointense and hyperintense on T1-and T2-weighted scans, respectively, was detected. During surgery, a well capsulated cyst was excised en bloc. On histological examination, a hydatid cyst was diagnosed. Her postoperative serological test was positive. Her whole body was scanned for any other organ involvement, but scans were all negative. She was treated with albendazol. After 3 months, the test result was negative, and there were no local or systemic recurrences. Primary subcutaneous tissue involvement is a rarely reported entity in the literature. To the best of our knowledge, this is the first case report of a primary subcutaneous hydatid cyst detected over the thoracic spine. (Turkiye Parazitol Derg 2014; 38: 264-9) Keywords: Echinococcus, hydatid cyst, magnetic resonance imaging, surgery Received: 21.05.2013Accepted: 11.06.2014 ÖZETHidatik hastalığı, endemik bölgelerde halk sağlığı problemi oluşturmaktadır. En sık karaciğer ve akciğerde tespit edilmekle beraber, nadir de olsa diğer dokuları da etkileyebilir. Altmış iki yaşında kadın hasta, torakal omurgası üzerinde ele gelen, haraketli kitle ile kliniğimize başvurdu. Manyetik rezonans görüntülemesinde, T1-ağırlıklı incelemede hipointens, T2-ağırlıklı incelemede hiperintens olan kistik bir kitle tespit edildi. Ameliyat kararı verilen hastanın cerrahisinde, ciltaltı yerleşimli kapsüllü yapıda bir kist en-blok çıkarıldı. Histolojik incelemede sonuç hidatik kist olarak bildirildi. Post-op bakılan ekinokok serolojisi pozitifti. Hastanın bütün vücudu olası diğer odaklar için tarandı; fakat sonuç negatifti. Üç ay boyunca albendazol tedavisi gören hastanın test sonuçları negatif geldi. Yerel veya sistemik hastalık tekrarı saptanmadı. Ciltaltı hidatik kist nadir bir klinik durumdur. Literatür taramamıza göre bu olgu torakal omurga üzerinde saptanan ilk primer cilt altı hidatik kist olgusudur.

Primary Hydatid Cyst of Umbilicus, Mimicking an Umbilical Hernia

“…We mentioned only a few cases reported to have primary abdominal wall lesions and most of them presented with right iliac or paraumbilical region [ 16 – 22 ]. Abhishek et al reported a painless cystic swelling with intramuscular extension in right paraumbilical region [ 23 , 24 ]. Burgazli et al detected a subcutaneous palpable mass in the left quadrant paraumbilical region [ 3 ].…”

“…Then, the cavity of cyst should be irrigated with scolicidal agents [ 3 , 4 , 23 – 25 ]. In some studies, treatment with albendazole is suggested to be beneficial for preventing the postoperative recurrence of hydatid cyst disease of abdominal wall but with regard to the low prevalence of hydatid disease in abdominal wall, it was not yet studied [ 3 , 23 , 24 ].…”

Hydatid cyst of the spine with paraspinal and extradural location: a report of three cases and review of the literature

“…On MR images, extradural cysts are usually multiple and involve the bone (Fahl et al, 1994). Lesions appear hypointense on T1-weighted images and hyperintense on T2-weighted images (Arif and Zaheer, 2009;Eksi et al, 2014). CT and MR imaging are more valuable in the diagnosis of this condition than conventional radiography (Sami et al, 1996).…”