AN UNUS UAL CAS E OF

HYDATI D CYST IN TH E
TH IG H
*Dr.(prof)A.K.Sharma(MS)
**Dr.Gambheer Singh(MS)
***Dr.Rajan Kumar
INTRO DUC TI ON
 35 years old male
patient
 Palpable mass in
right upper thigh in
posteromedial
aspect
 Duration – 12 years
 Pain since 1 month
 No H/O animal
contact
O/E:-
 Solitary swelling
 8x9 cm ovoid in shape
 Soft to firm in consistency
 Non tender
 Smooth surface
 Overlying skin was normal
 Well defined margin
 No impulse on coughing
 No pulsation.
O/ E (contd.)
 Mobility  Freely mobile in
relaxed position
 Restricted on
muscle contraction
 Absent
 Fluctuation
 Absent
 Transillumination
 Dull
 Percussion
 No bruit,no thrill
 auscultation
Diff erentia l Di agnosis

 Rhabomyosacroma
 Lipoma
 Liposarcoma
 Neurofibroma
 Hydatid cyst
INVE STI GAT IO NS
 Routine lab  With in normal limit
investigation
 Eosinophil count  With in normal limit
 FNAC  Inconclusive
 USG lump right  a fusiform lesion
thigh  multiple variable
sized cysts with in it
 well defined
capsulated
 intramuscular
OP ERATI ON
 F/S/O hydatid cyst
right thigh
 surgery was planned
 complete excision of
well encapsulated
intramuscular cystic
lump done with
preservation of all
important vessel,
nerves and muscles
Gr oss Ex amin ation
Mic rosc opic
Ex amin ation
Hist opatholo gy

 On gross examination, there were

multiple daughter cysts were present with
in the mother cysts, hydatid fluid and
sand were present.
 On histological examination it is
consistent with features of HYDATID
CYST
Po st -o perative Eve nt

 Post operative period – uneventful

 Patient - discharged after removal of all
stitches
 Wound - healthy
 Advise – to take mebendazole for 4
weeks
 Bayram and siricki reported the 1st
intermuscular hydatid cysts in forearm
region of 18 year old man
 More than 90% of hydatid cysts occur in
the liver, lungs, or both.
 Peripheral organ hydatidosis is much
less common
 Few embryos can escape the capillary
filtering systems of the liver and lung.
 Primary hydatid disease of the skeletal
muscle
 Rare
 In 3% of patients.
 Muscle is inhospitable for echinococcal
interactions because of its contractility
and high level of lactic acid.
 Most of the previous reports of primary
muscular hydatidosis have been isolated
intramuscular localizations

 Preoperative diagnosis and evidence of

diagnostic biopsy or aspiration is crucial
in preventing local recurrence, cystic
infection, and anaphylactic shock.
Se nsit ivity o f se rolo gy

 Liver 80-100%
 Lung cyst infection 55%
 Other organ
25-56%
involvement

USG is reliable non invasive

method to diagnose hydatid cyst
CON CL USI ON

 Hydatid cyst should be

considered in the differential
diagnosis of soft tissue
swelling, especially in endemic
areas.