Skip to content
BY 4.0 license Open Access Published by De Gruyter Open Access May 22, 2022

Intramuscular hydatid cyst of thigh masquerading as a soft tissue tumour diagnosed by fine needle aspiration cytology

K Amita EMAIL logo , T Rajini , M Sanjay , MG Abhishek and K Prashantha
From the journal Cell Pathology

Abstract

Introduction. Hydatid cyst, caused by Echinococcus granulosa, occurs rarely in the musculoskeletal region. Most of the time, clinically and radiologically it is diagnosed as a soft tissue tumor, benign or malignant. There are a few case reports of hydatid cyst presenting as an intramuscular thigh mass, which has been diagnosed at fine needle aspiration cytology (FNAC). Accurate pre-operative diagnosis is essential in view of specific therapeutic options for this disease. Here we report a case of hydatid cyst occurring in an unusual location (thigh) and masquerading as a soft tissue tumour, diagnosed at FNAC. Case Report. 56-year-old male patient presented with gradually increasing swelling of the left thigh since 3 years. On examination, there was a firm non-tender 25 × 20 cm swelling on the posterior aspect of left thigh extending from the gluteal region to five cm above the knee joint. An ultrasound diagnosis of a soft tissue tumor was made. At FNAC, fluid was aspirated and smears showed granulomas along with multiple hyaline acellular membrane-like fragments, few showing vague laminations. A diagnosis of hydatid cyst was made at FNAC which was corroborated at histopathology. Conclusion. Intramuscular hydatid cyst of the thigh is a very rare manifestation. The possibility of hydatid cyst should be considered while aspirating any soft tissue mass lesion, especially when fluid is obtained and microscopy shows acellular hyaline membrane-like material, even when fewer laminations are noted.

References

[1] Gochhait D, Dey P, Rajwanshi A, Nijhawan R, Radhika S, Gupta N. Spectrum of fungal and parasitic infections on fine needle aspiration cytology. Diagn Cytopathol. 2015 Jun;43(6):450–5.10.1002/dc.23247Search in Google Scholar

[2] Yalavarthi S, Satya NV, Ramamurti T, Supriya M. Intermuscular hydatid cyst in the thigh: an unusual presentation. Med J DY Patil Univ. 2013;6(2):191–3.10.4103/0975-2870.110311Search in Google Scholar

[3] Shah E, Shah S. A rare case of primary hydatid cyst of right thigh. J Clin Diagn Res. 2019;13(2):PD01–02.10.7860/JCDR/2019/39525.12541Search in Google Scholar

[4] Mujawar P, Suryawanshi KH, Nikumbh DB. Cytodiagnosis of isolated primary hydatid cyst of breast masquerading as a breast neoplasm: A rare case report. J Cytol. 2015 Oct-Dec;32(4):270–2.10.4103/0970-9371.171248Search in Google Scholar

[5] Kazmi Z, Qureishi S, Quraishy MS, Mallick FA, Rizvi S. Atypical presentation of hydatid cyst in the thigh. J Coll Physicians Surg Pak. 2017 Jan;27(1):51–2.Search in Google Scholar

[6] Kazakos CJ, Galanis VG, Verettas DA, Polychronidis A, Simopoulos C. Primary hydatid disease in femoral muscles. J Int Med Res. 2005 Nov-Dec;33(6):703–6.10.1177/147323000503300613Search in Google Scholar

[7] Ates M, Karakaplan M. Hydatid cyst in the biceps and gluteus muscles: case report. Surg Infect (Larchmt). 2007 Aug;8(4):475–8.10.1089/sur.2006.040Search in Google Scholar

[8] Sinan T, Sheikh M, Chisti FA, Al Saeed O, Sheikh Z, Hira PR, et al. Diagnosis of abdominal hydatid cyst disease: the role of ultrasound and ultrasound-guided fine needle aspiration cytology. Med Princ Pract. 2002 Oct-Dec;11(4):190–5.10.1159/000065809Search in Google Scholar

[9] Thursky K, Torres J. Primary Muscle Hydatidosis of the Thigh: Management of a complicated case with combination adjunctive Albendazole and Praziquantel chemotherapy. Clin Infect Dis. 2001 Feb 1;32(3):E65-8.10.1086/318521Search in Google Scholar

[10] Salai M, Apter S, Dudkiewicz I, Chechik A, Itzchak Y. Magnetic resonance imaging of hydatid cyst in skeletal muscle. J Comput Assist Tomogr. 1999 Mar-Apr;23(2):331–2.10.1097/00004728-199903000-00031Search in Google Scholar

[11] Kammerer WS, Schantz PM. Echinococcal disease. Infect Dis Clin North Am. 1993 Sep;7(3):605–18.10.1016/S0891-5520(20)30545-6Search in Google Scholar

[12] Rickard MD, Honey RD, Brumley JL, Mitchell GF. Serological diagnosis and post-operative surveillance of human hydatid disease. II. The enzyme-linked immunosorbent assay (ELISA) using various antigens. Pathology. 1984 Apr;16(2):211–5.10.3109/00313028409059107Search in Google Scholar PubMed

[13] Das DK, Bhambhani S, Pant CS. Ultrasound guided fine-needle aspiration cytology: diagnosis of hydatid disease of the abdomen and thorax. Diagn Cytopathol. 1995 Mar;12(2):173–6.10.1002/dc.2840120219Search in Google Scholar PubMed

[14] Bret PM, Fond A, Bretagnolle M, Valette PJ, Thiesse P, Lambert R, et al. Percutaneous aspiration and drainage of hydatid cysts in the liver. Radiology. 1988 Sep;168(3):617–20.10.1148/radiology.168.3.3043542Search in Google Scholar PubMed

[15] Gupta R, Mathur SR, Agarwala S, Kaushal S, Srivastav A. Primary soft tissue hydatidosis: aspiration cytological diagnosis in two cases. Diagn Cytopathol. 2008 Dec;36(12):884–6.10.1002/dc.20936Search in Google Scholar PubMed

[16] Sáenz-Santamaría J, Catalina-Fernández I, Fernández de Mera JJ. Hydatid cyst in soft tissues mimicking malignant tumors. Diagnosis by fine needle aspiration cytology. Acta Cytol. 2003 May-Jun;47(3):337–40.10.1159/000326530Search in Google Scholar PubMed

[17] Meshram N, Kamal F, Gadkari R. Hydatid cyst of breast: unwelcome guest at unusual site; a case report and review of literature. International Journal of Contemporary Medical Research. 2021;8(1):A12–6.Search in Google Scholar

Received: 2021-04-10
Accepted: 2022-04-08
Published Online: 2022-05-22

© 2021 K Amita et al., published by De Gruyter

This work is licensed under the Creative Commons Attribution 4.0 International License.

Downloaded on 28.1.2023 from https://www.degruyter.com/document/doi/10.1515/ersc-2021-0003/html
Scroll Up Arrow