Lower back musculoskeletal hydatid cyst: a rare presentation in a South Sudanese patient

Abstract

Echinococcosis (hydatidosis) remains a crucial public health concern in areas of endemicity including South Sudan. It affects mostly liver and lungs but rarely musculoskeletal system. A female, aged 75 years, presented to Kapoeta State Hospital, with a three years’ history of a painless mass on her back, gradual onset. There was no history of trauma, pain or fever. On examination there was a mass of 8cm x 5cm, soft, non-tender and lobulated on the right lower back above the gluteal region with intact skin. Imaging investigations (ultrasound, X-ray, CT scan) were not available. A provisional diagnosis of a lipoma was made. Surgery was done successfully and a hydatid cyst was found and removed. There were no post-operative complications. She was discharged on the next day with oral albendazole (400mg), twice a day for 28 days. Six months later, the patient was seen with no complains or recurrence. In endemic areas hydatid cysts should be considered in the differential diagnosis of any cystic swelling or lump. In low resource countries, incorporation of health education to school curriculum will play a key role in reducing incidence or prevalence of the disease.

Primary intramuscular thigh hydatid cyst: A case report

“…Although lungs and liver are the most commonly involved organs by the disease; involvement of any organ in the body including the heart, bones, muscles, spleen, kidneys, brain, and eyes have been reported rarely [ 9 ]. The presence of hydatid cyst in the muscle is unusual and accounting for about less than 1 % of all hydatid cysts [ 3 , 4 ]. Theoretically, the muscular environment is unfavorable to the growth of hydatid larvae due to the high level of lactic acid in muscle tissue [ 10 ].…”

“…Theoretically, the muscular environment is unfavorable to the growth of hydatid larvae due to the high level of lactic acid in muscle tissue [ 10 ]. Numerous muscle localizations have been reported; the involvement predominates in the neck, trunk, and limb-root muscles [ 4 , 11 , 12 ]. The volume of the muscle mass and the quality of its blood supply may be responsible for the preferential localization in the proximal muscles of the lower limbs [ 13 ].…”

“…It mostly involves the liver and lungs [ 2 ]; however, muscle involvement is an uncommon event. Only a few cases of hydatid cyst within muscles have been reported in the literatures [ 3 , 4 ]. A high index of suspicion is required to diagnose hydatid cyst in such locations, even in endemic areas.…”

Hydatid Cyst of the Thigh: A Report of a Rare Case With Literature Review

“…However, there have been sporadic reports highlighting the disease's manifestation in diverse anatomical structures such as the heart, bones, spleen, kidneys, brain, and eyes. Remarkably, the musculoskeletal system's involvement is an uncommon phenomenon, constituting less than 1% of all diagnosed HC cases [12,13].…”