Primary Isolated Intramyometrial Cystic Echinococcosis Presenting with Life-Threatening Anemia

Cystic echinococcosis usually involves the liver and lungs, whereas uterine involvement is uncommon. A surgically confirmed case of primary intramyometrial echinococcosis in northern Kenya is described. A 29-year-old woman presented with severe anemia secondary to heavy menstrual bleeding. Ultrasound revealed a 12 × 12 × 14 cm intramyometrial anechoic lesion initially interpreted as a degenerating leiomyoma. An open myomectomy allowed for an intact excision without rupture. Histopathology revealed laminated acellular membranes and protoscolices consistent with cystic echinococcosis. Hepatic ultrasound and chest radiography revealed no other organ involvement. In endemic settings, hydatid disease should be considered in the differential diagnosis of cystic uterine masses. Preoperative suspicion may reduce the risk of rupture, dissemination, and inappropriate surgical planning.