MUSCULOSKELETAL HYDATIDOSIS: REPORT OF TWO СASES AND REVIEW THE LITERATURE

Abstract

Musculoskeletal system is rarely involved by hydatid cyst, the larvalform of Echinococcus granulosus. Two cases of intramuscular hydatid cysts within thigh musculature are being reported with the intent of highlighting this atypical localization of the disease. Preoperative computerized tomography suggested an unusual location of echinococcus. Since the soft tissue tumors may be confused with hydatid cysts, preoperative evaluation of these patients is critical for proper handling during surgery to avoid life-threatening complications. Surgical excision with postoperative antihelmenthics formed the main modality. These cases emphasize that especially in endemic areas to avoid fine-needle biopsy and the risk of spillage of cyst contents hydatidosis should be included in differential diagnosis of any soft tissue mass.

Keywords

Echinococcus granulosus / intramuscular hydatid cyst / preoperative computerized tomography / fine-needle biopsy / postoperative antihelmenthics / albendazole

References

[1] Бессонов А.С. Цистный эхинококкоз и гидатидоз. - М., 2007.

[2] Бронштейн А.М., Малышев Н.А., Лучшев В.И., Давыдова И.В. Социально-эпидемиологические проблемы и основные вопросы патологии и химиотерапии гельминтозов органов пищеварения // Рос. мед. журн. - 2007. - № 2. - С. 33-36.

[3] Бронштейн А.М., Малышев Н.А. Паразитарные болезни органов пищеварения // руководство по гастроэнтерологии / Под ред. Ф.Ф. Комарова, С.И. Рапопорта. - М., 2010. - С. 657-692.

[4] Бронштейн А.М., Малышев Н.А., Жаров С.Н. и др. Эхинококкозы (гидатидозный и альвеолярный) - пограничная проблема медицинской паразитологии и хирургии // Рос. мед. журнал. - 2012. - № 3. - С. 50-53.

[5] Давыдова И.В., Легоньков Ю.А., Бронштейн А.М., Межгихова Р.М. Случай глубокой депрессии гранулоцитопоэза у больной цистным эхинококкозом, леченной албендазолом // Мед. паразитол. - 2007. - № 4. - С. 53-56.

[6] Дейнека И.Я. Эхинококкоз человека. - М., 1968.

[7] Морозов Е.Н. Перспективы применения методов молекулярной паразитологии в мониторинге социально значимых паразитозов // Справочник зав. КДЛ. - 2011. - № 4. - С. 13-20.

[8] Мусаев Г.Х., Ветшев П.С. Эхинококкоз: состояние проблемы // Клин. перспект. гастроэнтерол., гепатол. - 2005. - № 4. - С. 7-12.

[9] Петровский Б.В., Милонов О.Б., Дееничин П.Г. Хирургия эхинококкоза. - М., 1985.

[10] Alimehmeti R., Seferi A., Rroji A. et al. Saphenous neuropathy due to large hydatid cyst within long adductor muscle: case report and literature review // J. Infect. Dev. Ctries. - 2012. - Vol. 6, N 6. - P. 531-535.

[11] Basarir K., Saglik Y., Yildiz Y. et al. Primary muscular hydatidosis mimicking soft tissue tumour: a report of five cases // J. Orthopaed. Surg. - 2008. - Vol. 16, N 3. - P. 368-372.

[12] Bilanović D., Zdravković D., Randjelović T. et al. Lesion of the femoral nerve caused by a hydatid cyst of the right psoas muscle // Srp. Arh. Сelok Lek. - 2010. - Vol. 138, N 7-8. - P. 502-505.

[13] Bilgic S., Kose O., Sehirlioglu A. et al. Primary paraspinal hydatid cyst treated with puncture, aspiration, injection and re-aspiration (PAIR) technique: a case report // Eur. Spine J. - 2009. - Vol. 18, Suppl. 2. - P. 165-167.

[14] Brunetti E., Kern P., Vuitton D.A. Writing Panel for the WHO-IWGE. Expert consensus for the diagnosis and treatment of cystic and alveolar echinococcosis in humans // Acta Trop. - 2010. - Vol. 14. - P. 1-16.

[15] Craig P.S., Budke C.M., Schantz P.M. et al. Human echinococcosis: a neglected disease? // Trop. Med. Hlth. - 2007. - Vol. 35. - P. 283-292.

[16] Eckert J., Deplazed P. Biological, epidemiological, and clinical aspects of echinococcosis, a zoonosis of increasing concern // Сlin. Microbiol. Rev. - 2004. - Vol. 7, N 1. - P. 107-135.

[17] En-Nafaa I., Moujahid M., Alahyane A. et al. Hydatid cyst of the liver ruptured into the abdominal wall and the psoas muscle: report of a rare observation // Pan. Afr. Med. J. - 2011. - Vol. 10. - P. 3-5.

[18] Ergul E., Ucar A.E., Yalcin S. Primary hydatid cyst in an unexpected localization // Bratisl. Lek. Listy. - 2012. - Vol. 13, N 1. - P. 50-51.

[19] Insabato L., Marino G., Fazioli F. et al. Primary intramuscular infestation of Echinococcus granulosus misdiagnosed as a soft tissue tumor: a case report // Acta Cytol. - 2007. - Vol. 51, N 4. - P. 631-633.

[20] Iuliano L., Gurgo A., Polettini E. et al. Musculoskeletal and adipose tissue hydatidosis based on the iatrogenic spreading of cystic fluid during surgery: report of a case // Surg. Today. - 2000. - Vol. 30, N 10. - P. 947-949.

[21] Jellad A., Boudokhane S., Ezzine S. et al. Femoral neuropathy caused by copmpressive iliopsoas hydatid cyst: a case report and review of the literature // J. Bone Spine. - 2010. - Vol. 77, N 4. - P. 371-372.

[22] Mahmood N.S., Mokhtari M., Abbasi F.S., Nouriyan N. Primary solitary hydatid cyst in paraspinal cervical muscles: a case report and review of the literature // Neurol. Neurochir. Pol. - 2011. - Vol. 45, N 4. - P. 387-390.

[23] Motie M.R., Rezapanah A., Pezeshki R.M. et al. Primary localization of a hydatid cyst in the latissimus dorsi muscle: an unusual location // Surg. Infect. (Larchmt). - 2011. - Vol. 12, N 15. - P. 401-403.

[24] New dimensions in hydatidology in the new millennium. Proceedings of the 20th International congress of hydatidology. June 4-8, 2001, Kusadasi, Turkey // Acta Trop. - 2003. - Vol. 85. - P. 103-293.

[25] Ormeci N., Idilman R., Akyar S. et al. Hydatid cysts in muscle: a modified percutaneous treatment approach // Int. J. Infect. Dis. -2007. - Vol. 11. - P. 204-208.

[26] Pathak T.K., Roy S., Das S. et al. Solitary hydatid cyst in thigh without any detectable primary site // J. Pak. Med. Assoc. - 2011. - Vol. 61, N 12. - P. 1244-1245.

[27] Sarisoy H.T., Memisoglu K., Tamer G.S., Sarlak A.Y. Primary hydatid disease in adductor muscles // Сііп. Invest. Med. - 2008. - Vol. 31, N 5. - P. 296-299.

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