Primary hydatid cysts of the soft tissues

Case contributed by Ammar Haouimi
Diagnosis almost certain

Presentation

Admitted to the hospital with pain in the left thigh. Physical examination reveals multiple masses along the medial and posterior aspect of the left thigh extending from the groin up to the popliteal region. Chest x-ray and abdominal ultrasound were normal.

Patient Data

Age: 85 years
Gender: Female

Multiple intra-and inter-muscular multivesicular cysts of various size and shape (round, oval, serpiginous), extending from the groin up to the knee. These cysts appear of low T1, high T2 with low signal of the cystic wall. There were no enhancement of the cystic wall after gadolinium administration (not shown).

Case Discussion

Soft tissue hydatid disease is unusual, even in endemic areas.

The soft tissue hydatid cysts are usually secondary, and have a predilection for the lower limbs. Primary hydatidosis of skeletal muscle is rare, with reported prevalence of 0.5–4.7%.

It is believed that the contractile nature of the muscles, and high level of lactic acid of muscle diminishes the growth process of the oxygen-dependent cysts.

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