Echinococcus granulosus in atypical localizations: Five case reports.

Abstract

Background: Hydatid cyst disease, caused by Echinococcus granulosus, primarily affects the liver and lungs, but it can also develop in rare locations such as the kidneys, thyroid, subcutaneous tissues, bones, and the mediastinum. These atypical presentations often pose diagnostic challenges, as they can mimic benign and malignant pathologies, leading to potential misdiagnoses and inappropriate treatments. Early and accurate detection of hydatid cysts in uncommon sites is crucial for optimal patient management.

Case summary: This case report series presents five patients with hydatid cysts located in atypical anatomical regions: The kidney, lumbar subcutaneous tissue, gluteal soft tissue, posterior mediastinum, and thyroid gland. The patients exhibited diverse clinical symptoms, including hematuria, palpable masses, localized pain, and chronic cough. Diagnosis was confirmed through a combination of imaging techniques-ultrasound, computed tomography, and magnetic resonance imaging-along with serological testing. All cases were managed with antiparasitic therapy (albendazole), and in selected cases, surgical excision was performed to prevent complications such as cyst rupture or secondary infections. Post-treatment follow-up demonstrated complete resolution or stable cystic lesions, with no signs of recurrence.

Conclusion: Recognizing hydatid cysts in atypical locations is essential to avoid misdiagnosis and ensure appropriate treatment strategies. Radiological imaging plays a key role in distinguishing hydatid cysts from other cystic and neoplastic conditions, while serological tests can aid in confirmation, particularly in endemic regions. A multidisciplinary approach, integrating radiology, clinical evaluation, and surgical expertise, is critical for effective diagnosis and management. This report highlights the need for increased awareness of extrapulmonary and extravisceral hydatid disease, emphasizing its significance in differential diagnosis and clinical practice.