Atypically Located Hydatid Cyst Cases: Four Unusual Case Reports

Abstract

Hydatid cysts are frequently located in liver (65-70%) and lungs (25%). The disease is usually asymptomatic when located in the extrahepatic regions. Sometimes, diagnosis can be established by observing germinative membrane, rockwater, or daughter vesicles during the operation.. A 41-year-old female patient applied with the complaint of intermittent left inguinal pain. Echinococcus Indirect Hemagglutination (IHA) test was positive. In the ultrasonographic examination, a hypoechoic area was observed in the posteromedial of the left femoral head.. A 56-year-old female patient, applied with the complaints of intermittent nausea, vomiting, and epigastric pain. She had a history of surgery for liver hydatid cyst 15 years ago and for lung hydatid cyst 10 years ago. IHA test of the patient was positive. The lesion involving septation and accompanied by calcifications around the cyst was reported as a hydatid cyst at dynamic CT for pancreas and upper abdominal MRI. A 22-year-old female patient applied with perianal pain complaint. Drainage was planned for the patient who had a pre-diagnosis of perianal abscess. Tissues similar to the hydatid cyst membrane were excised together with purulent fluid. The patient was diagnosed with hydatid cyst after the pathology result was reported “as compatible with hydatid cyst”. A 32-year-old female patient had a non-metabolic adrenal subcapsular cyst (hydatid cyst?) in the right adrenal gland on ultrasonography performed for abdominal pain. In abdominal tomography, a “cystic mass compatible with hydatid cyst located in the adrenal gland in the upper pole of the right kidney” was reported. IHA test of the patient was negative. Hydatid cysts located in the perianal region and muscles have been reported as atypical localizations in the literature, and some of them were diagnosed as a result of preoperative clinical evaluation and radiological imaging. Some were diagnosed as a result of pathological examination after the operation. Surgical treatment is an option in suitable cases, and the definitive diagnosis can be established by pathology. Consequently, it should be considered that cystic lesions detected in the patients living in endemic regions can be extrahepatic hydatid cyst that is localized in different anatomical regions.