The deceptive cysts of echinococcus granulosus in the thigh: A case series and review of diagnostic and management challenges
Abstract
Introduction Hydatid cyst disease, caused by the larval stage of Echinococcus granulosus, is a zoonotic parasitic infection that is endemic in many regions of the world. Musculoskeletal involvement, particularly in the thigh, is rare, accounting for approximately 1–4 % of all hydatid cyst cases. This case series aims to contribute valuable information by presenting three distinct cases of hydatid cyst affecting different compartments of the thigh. Cases presentation We detail the diagnostic process, surgical and medical management strategies, and outcomes observed during the follow-up period for each patient. The patients, including two livestock breeders from rural areas with close contact with sheep and dogs and one housewife from an urban area with no known animal contact, presented with a slowly enlarging mass in the thigh. Diagnosis involved clinical evaluation, advanced imaging techniques such as ultrasound and MRI, and serological testing. MRI revealed multiple cystic lesions with internal septations and daughter cysts in all cases. Serological tests for E. granulosus antibodies using ELISA were positive in two cases but initially negative in one. Treatment included pre-operative and post-operative albendazole therapy (10–15 mg/kg/day) and surgical excision of the cysts, with careful technique to avoid spillage and the use of scolicidal agents such as hypertonic saline, hydrogen peroxide, and povidone‑iodine. Discussion Hydatid cyst of the thigh is a rare condition…
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