Two hydatid cysts in the psoas muscle of a 40-year-old female: A rare case report from Syria

Abstract

Background: Hydatid disease, a zoonotic infection common in pastoral areas, can affect any human organ. Muscular involvement, especially in the psoas muscle, is rare, comprising only 1-3% of cases, even in endemic regions. The presence of multiple cysts is even rarer. Clinical presentation varies, making them challenging to diagnostic. Surgical intervention is the primary treatment for psoas hydatid cysts. Case presentation: A 40-year-old female from a rural area presented with fatigue and abdominal pain, without constipation or changes in appetite. Physical examination revealed tenderness in the right hypochondrium. Her medical history included tonsillectomy twenty years ago, cesarean delivery two years ago, and pulmonary hydatid cystectomy seven years ago. Ultrasound detected a retroperitoneal hydatid cyst, while a multi-slice CT scan showed a hydatid cyst within the left psoas major muscle and an additional cyst in the anterior and lateral portions of the left psoas major muscle. Surgeries successfully removed two cysts from the left psoas major muscle, and the patient was discharged in good condition two days post-surgery. Conclusions: This case highlights the rarity of psoas major muscle hydatid cysts in a middle-aged woman from a rural area. Early recognition, accurate radiological assessment, and proper surgical treatment are crucial for positive outcomes and averting complications like infection, compression of nearby structures, or anaphylactic reactions.