Primary hydatid disease of the skeletal muscle without systemic involvement is rare. The purpose of this report is to document the novel clinical presentation and the interesting facets of fine-needle aspiration in a case of hydatid disease. It was a case of primary hydatid cyst of the left supraspinatus muscle in an Indian woman living in Kuwait, which was clinically diagnosed as a lipoma. Fine-needle aspiration (FNA) yielded 2 ml of clear fluid with white particulate material. The cytocentrifuged smears prepared from the aspirated fluid showed many scolices, occasional laminated cyst wall fragments and numerous hooklets. The laminated cyst wall and scolices were PAS positive. Trichrome staining imparted a demon-head-like appearance to the scolices. The cytodiagnosis of hydatid cyst was corroborated by histopathological examination of an excised whitish membrane and an irregular cystic fragment, which showed parallel laminations without germinal layer, and skeletal muscle with granulomas and a dense eosinophilic infiltration, respectively. Quantitative serological (indirect hemagglutination) test on blood sample collected 9 days after the excision of the cyst showed insignificant antibody titer to Echinococcus sp. and after 6 weeks the antibodies were completely absent. CT scan of the chest and abdomen performed 7 weeks after removal of cyst showed no evidence of visceral hydatid cyst. Diagn. Cytopathol. 2014;42:268–272. © 2012 Wiley Periodicals, Inc.

Primary hydatid cyst of the supraspinatus muscle: Complete removal of the germinal layer and cytodiagnosis by fine-needle aspiration

Hydatid disease of the organs other than liver and lung is extremely rare. Although hydatid disease is endemic in India, we report a rare case of hydatid cyst in a young male primarily involving the seminal vesicle and aim to highlight the management of such cases. A 23 year old male farmer diagnosed with primary isolated echinococcal cyst of the seminal vesicle has been presented. Thorough investigations with radiological methods such as ultrasonography (abdominal and trans-rectal), and magnetic resonance imaging were carried out to aid in the diagnosis. Surgical excision of the lesion was carried out with careful removal of the cyst to prevent any bursting and spillage, leaving the seminal vesicle preserved. The cystic lesion was subjected to histopathological examination. Histopathology confirmed the diagnosis of hydatid disease. Postoperative period was uncomplicated and patient was discharged on seventh postoperative day. Patient was put on albendazole (10 mg/kg/day) for three cycles of 21 days each with a gap of one week between each cycle. There was no evidence of recurrence or development of cysts elsewhere in the body during the 2 year follow-up. Hydatid cyst of seminal vesicle is rare and should be kept in differential diagnosis of a cystic lesion in pelvis especially in regions where hydatid disease is endemic. Proper surgical and medical management to avoid any recurrences, and a regular follow-up, are of utmost importance to detect any late complications such as local recurrence of the disease and development of hydatidosis at the primary sites.

Primary isolated echinococcal cyst of the seminal vesicle: A rare case

Echinococcosis, which is caused by echinococcus granulosus, is also known as cystic hydatid disease, unilocular echinococcosis or cystic echinococcosis. Cystic echinococcosis is an alarming public health problem in some countries. Although the liver and lung are the organs involved most commonly by the disease, it may appear rarely in other tissues as a primary disease. Here, we present a 66-year-old patient who is invoved in farm work work. A Uterine multiseptate hydatid cyst was found on radiological investigations and the patient underwent surgery. A total hysterectomy was carried out. There were no postoperative complications.

Primary uterine hydatid cyst: a case report

Here, we present a rare case of a hydatid cyst in a 25-year-old woman, mimicking a uterine leiomyoma. The patient was admitted with lower abdominal pain and tenesmus, and ultrasonographic examination revealed a 10×10 cm uniloculated mass with regular borders in the myometrium. The patient was operated with an initial diagnosis of a uterine leiomyoma with cystic degeneration, which was found to be hydatid cyst during frozen section and confirmed with the identification of protoscoleces during microscopy. This rare case report indicates the necessity of considering hydatid disease in the differential diagnosis of pelvic cysts, especially in endemic regions.

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Primary Hydatid Cyst Mimicking Uterine Leiomyoma.

Echinococcosis or Hydatid disease is one of the important zoonotic, as well as occupational disease with worldwide distribution. In India, hydatid disease is endemic. However, hydatid disease of ovary is uncommon condition. We report such a case of ovarian hydatid disease in an 11‑year‑old girl, from rural Gujarat, Western India, presenting with symptoms of urinary obstruction. This case report highlights the rarest location of the Echinococcosis. Key words: Echinococcosis, hydatid disease, ovarian hydatid

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Ovarian Hydatid Cyst in Pediatric Patient Commencing as Ovarian Tumor: A Rare Site of Echinococcosis

. A 50-year-old female presented with a swelling in the left gluteal region (upper outer region) since two years which was gradually increasing in size. Fine needle aspiration cytology of the swelling was done which was inconclusive. Incisional biopsy of the swelling done at some peripheral hospital revealed hydatid cyst. Based on histopathological examination, ultrasonography and magnetic resonance imaging features along with positive serology diagnosis of solitary gluteal subcutaneous hydatid cyst was made and total cystectomy (cystopericystectomy) was done. Post-operatively patient was put on albendazole. Larval stage of Echinococcus is the cause of hydatid cyst. Four species of Echinococcus tapeworm can produce disease in humans viz E.granulosus and E.multilocularis cause cystic and alveolar hydatid disease respectively, while E.vogeli and E.oligarthus rarely infect humans. Hydatid cyst of subcutaneous tissue is extremely rare, and this case report highlights the rarest location of the hydatid cyst. Key words: Hydatid cyst; subcutaneous tissue

Sajjid H Batt

Papers

Solitary subcutaneous gluteal hydatid cyst: a case report