Musculoskeletal Hydatid Cyst around Pelvis: A Case Report and Review of Literature

Human hydatid disease is a parasitic infection caused by Echinococcus granulosus. Bone involvement is only about 0.2-3% of all hydatid cyst cases [1]. Within bone hydatidosis, pelvic sites constitute a minority compared to vertebrae and long bones.

A 25-year-old female from a rural background presented to our outpatient department with complaints of recurrent swelling in the left lower abdominal quadrant for the past 4 months, which had been gradually increasing in size. She had been treated elsewhere for similar complaints 3 years back, where she was evaluated and managed with surgical excision of the cystic swelling, and was asymptomatic for a period of 3 years. The patient was diagnosed with Hydatid disease involving the body of bilium and sacrum and was further evaluated with plain radiographs, computed tomography scan, and magnetic resonance imaging to identify the extent of the disease. A multidisciplinary team was involved for proper planning and involving the team of gastro-surgeon, orthopaedic surgeon and a plastic surgeon.

Bone hydatidosis is considered a rare condition, and surgical excision remains the cornerstone of treatment, although recurrence is frequent, particularly in anatomically challenging locations. Owing to the infiltrative behavior of the infection, complete surgical eradication is often difficult, and reported recurrence rates are on the higher side. To achieve a good functional outcome postoperatively, a good rehabilitation program and gait training are often required for achieving satisfactory functional outcome.