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Skeletal muscle hydatid cysts presenting as soft tissue masses
Hippokratia
|July 3, 2010
Summary
Muscle hydatidosis, a rare condition, involves echinococcosis cysts within skeletal muscles. Surgical excision combined with imaging and history is key for diagnosis and effective treatment of these rare muscle masses.
Area of Science:
- Medical Parasitology
- Musculoskeletal Imaging
- Surgical Pathology
Background:
- Muscle hydatidosis is an uncommon parasitic infection, representing 3-5% of all echinococcosis cases.
- Primary skeletal muscle echinococcosis is exceptionally rare, necessitating awareness in differential diagnoses.
Observation:
- A case series of nine patients (8 males, 1 female; mean age 59.3 years) with primary skeletal muscle echinococcosis is presented.
- Cysts manifested as soft tissue masses in the thigh, popliteal fossa, humerus, and shoulder, confined to muscles without bone involvement.
- Magnetic Resonance Imaging (MRI) revealed multi-vesicular cysts in all affected patients.
Findings:
- Indirect hemagglutination tests were positive in 6 of 9 patients.
- En bloc surgical excision was the primary treatment, with two patients receiving preoperative antihelminthic chemotherapy.
- Histopathology confirmed echinococcosis, and no recurrences were observed during 1-8 years of follow-up.
Implications:
- Skeletal muscle echinococcosis should be considered in the differential diagnosis of limb masses, particularly in endemic regions.
- Thorough patient history and advanced imaging like MRI are crucial for accurate diagnosis.
- Pericystectomy offers an effective treatment strategy for muscle hydatidosis, preventing recurrence.
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