Clinical Image Description

      Hydatid cyst disease is an endemic infestation caused by Echinococcus Granulosus parasite, it is a public health problem in mediterranean region, liver and lungs are affected sites of predilection but muscle localization is very rare [1].

      A 38-year-old female presented with painless swelling of right gluteus region, (Figure 1) ultrasonography demonstrated a large subcutaneous multivesicular hydatid cyst measuring approximately 150 × 110 mm, classed Gharbi’s type III with multiple daughter cysts forming honeycomb pattern (Figure 2A), MRI confirmed diagnosis and deep extension to the gluteus maximus (Figure 2B). Complete surgical excision was done (Figure 3).

      Primary muscular hydatid cyst is often asymptomatic and palpable mass is unique sign, but symptomatic in case of neurovascular compression, soft-tissue tumors are principal differential diagnosis. Operative treatment without perforating membranes, must be associated with pre and postoperative Anthelminthic drugs to avoid anaphylaxis, vascular dissemination and recurrences [2].

References

1. Tekin R, Avci A, Tekin RC, Gem M, Cevik R. Hydatid cysts in muscles: clinical manifestations, diagnosis, and management of this atypical presentation. Rev. Soc. Bras. Med. Trop. 2015; 48: 594-8.
2. Seyedsadeghi M, Ghobadi J, Haghshenas N, Habibzadeh A. Gluteal Hydatid Cyst: A Case Report. Iran J Parasitol. 2019; 14: 487- 91.