Povidone-Iodine Sterilization and Surgical Drainage for Musculoskeletal Hydatid Cysts: An Alternative to Wide...

Hydatid disease is a parasitic infection caused by Echinococcus granulosus and Echinococcus multilocularis. Due to the rarity of musculoskeletal involvement and occasional confusion with tumors, delays in diagnosis and treatment may occur. This study aimed to evaluate the outcomes of patients with musculoskeletal soft-tissue hydatid cysts treated with surgical drainage followed by povidone-iodine application as an alternative to wide excision.

In this retrospective study, the clinical characteristics and follow-up outcomes of patients treated between 2016 and 2024 were reviewed. The patients included in the study were considered to be high-risk for surgical morbidity and were unsuitable for wide excision. The patients included in the study received both preoperative and postoperative albendazole therapy.

The study included seven patients who met the inclusion criteria. The mean age was 45.7 years (range, 31-56 years), including four males and three females. The mean follow-up period was 4.2 years (range, 1-6 years). Lesions were located within the right iliacus muscle, the left hemipelvis, the proximal right thigh, and the hand and wrist region. Four patients had lesions involving the hand and wrist region. Throughout the follow-up period, no recurrence, wound infection, or clinically significant functional impairment was observed.

In patients with musculoskeletal hydatid disease, when en bloc cyst excision is not feasible, controlled cyst opening with mechanical evacuation followed by povidone-iodine sterilization, in conjunction with albendazole therapy, may represent an effective and viable alternative treatment option.