Unusual Localizations of Hydatid Disease

Abstract

Hydatid disease is endemic in several Mediterranean countries, posing an important health problem for these countries. The hydatid cyst is characterized by cystic lesions with clear boundaries, which can be observed in all parts of the body. Approximately 70 % of hydatid cysts are situated in the liver, followed by the lung (25 %). The kidneys, spleen, bile ducts, mesentery, soft tissue and brain are less frequent sites. We investigated patients who were treated for hydatid disease in our departments in the last 5 years with respect to localization of the disease, symptoms, surgical intervention, length of hospitalization, diameters of the cyst, and classification by Gharbi. In this retrospective and descriptive study, 176 patients are evaluated who were treated for hydatid disease between 1995 and 1999 in our departments. Of these patients, 14 were included with localization other than in the liver and lungs. Fourteen of the patients diagnosed with unusually located hydatid disease were men, six were women. Their mean age was 41.6 +/- 20.8 years; the length of hospital stay was 7.07 +/- 0.4 days. Overall, 28.6 % of patients with unusually located hydatid cyst had recurrent disease. The time period since last cyst operation was 5.25 +/- 3.5 years. The mean cyst diameter was 96.5 +/- 54.5 mm. According to Gharbi's classification, three cases (21.4 %) of the unusually located hydatid cysts were type I, two (14.3 %) type II, and eight (57.1 %) type III. There was only one case of type IV and no cases of type V. Spleen and kidneys are the organs where hydatid disease is most frequently observed after the liver and lung. It can be observed in all parts of the body including the brain, peritoneum, mesenterium, choledochus, pancreas, bone and muscles. The type of treatment is determined by the localization and type of hydatid disease. Surgical treatment for splenic hydatid cysts is splenectomy. The functional kidney should be saved in non-communicable hydatid disease. Total excision is almost never possible; endocystectomy and drainage procedure should be preferred for hydatid disease of the brain, pancreas and choledochus. Chemotherapy is usually given because of the risk of recurrence; this medical treatment consists in albendazole and mebendazole administration for 3-6 months in the postoperative period.

Primer Hydatid Cyst in Paravertebral Muscle

“…Computed tomography or ultrasound guided needle biopsies also are helpful in diagnosis (12), although some authors do not recommend it because of the risk of cyst rupture and anaphylactic reaction could occur (9,11). Concerns over microscopic spillage at the time of needle biopsy do not appear warranted, especially if patient receive subsequent medical treatment and biopsy tracts are resected at the time of surgery (13).…”

“…Postoperative medical treatment reduces recurrence rate. (14) Chemotherapy is usually given because of the risk of recurrence; this medical treatment consists of albendazole and mebendazole administration for 3-6 months in the postoperative period (11).…”

Unusual localizations of human hydatid disease in Hamedan province, west of Iran

“…Differential diagnosis between human CE and alveolar echinococcosis (AE) has significant implications for epidemiologic studies and treatment of these diseases, especially in the regions where both species occur sympatrically. Imaging methods, including ultrasonography, computerized tomography (CT), and magnetic resonance imaging (MRI), can provide a speciesspecific differential diagnosis in many cases, but diagnosis may be problematic in others (Ito et al, 1999;Çöl et al, 2003). Serodiagnostic tests based on antibody detection exhibit high sensitivity and reasonable specificity, for example detection of antibodies to the specific Em18 antigen, either immunoblot or ELISA, appears to be the most specific for AE.…”

“…Glycoproteins (GPs) purified from cyst fluid of Taenia solium are highly specific for diagnosis of T. solium neuorcysticercosis (NCC), and specific serological test for differentiation of NCC from echinococcosis is GP-ELISA or GP-immunoblot (Ito et al, 2003). The most common organ affected by hydatid disease is the liver (55 -70 %) followed by the lungs (20 -35 %) and the two organs are affected simultaneously in about 5 -13 % of cases (Abu-Eshy, 1998;Ahmadi & Hamidi, 2008 (Amr et al, 1994;Lucandri et al, 1994;Prousalidis et al, 1998;Kireşi et al, 2003;Çöl et al, 2003). In Iran, the adult stage of infection is commonly found among dogs, wolves, foxes and jackals (Fallah et al, 1995;Eslami & Hosseini, 1998;Dalimi et al, 2002), and the larval stage among livestock (Arbabi et al, 1998;Ansari-Lari, 2005;Dalimi et al, 2002;Ahmadi, 2005).…”

“…The most common organ affected by hydatid disease is the liver (55 -70 %) followed by the lungs (20 -35 %) and the two organs are affected simultaneously in about 5 -13 % of cases (Abu-Eshy, 1998;Ahmadi & Hamidi, 2008 (Amr et al, 1994;Lucandri et al, 1994;Prousalidis et al, 1998;Kireşi et al, 2003;Çöl et al, 2003). In Iran, the adult stage of infection is commonly found among dogs, wolves, foxes and jackals (Fallah et al, 1995;Eslami & Hosseini, 1998;Dalimi et al, 2002), and the larval stage among livestock (Arbabi et al, 1998;Ansari-Lari, 2005;Dalimi et al, 2002;Ahmadi, 2005). There are several reports of human infection with the parasite from different provinces in Iran (Sadrieh et al, 1967;Ahmadi & Dalimi 2006;Baharsefat et al, 2007;Pezeshki et al, 2007;Ahmadi & Hamidi, 2008).…”