Primary costal hydatid cyst resembling urolithiasis: A case report

Hydatid disease (HD) is a zoonotic infection caused by echinococcus granulosus tapeworms. HD accounts for approximately one million cases worldwide. HD is more prevalent in endemic areas, such as the Mediterranean region.

A middle-aged male patient presented with right flank pain for years. His vital signs and physical examination were unremarkable. The whole-body bone scan revealed an area along the sixth rib's posterior arch with increased metabolic activity and CT and MRI were compatible with a hydatid cyst. The cyst was surgically resected and irrigation of the area with hypertonic saline was done. Medical treatment with albendazole was initiated and the patient had no complications.

Bone involvement is an uncommon finding in HD and involvement of the ribs is even more scarce. Surgical resection complemented with medical treatment is the preferred approach.

In the Mediterranean and middle eastern regions, high infection rates with E. granulosis are evident hence, uncommon manifestations of the disease should be regarded. Although renal stones are far more prevalent when in endemic areas of HD, the physician should also consider skeletal HD as a differential diagnosis.