A case report of primary isolated extrahepatic hydatid cyst of the soft tissues of the breast and thigh

Introduction: Hydatid Disease (HD), or hydatidosis or echinococcosis, is an endemic infection and a major public health concern in the Mediterranean region. At times it involves the primary soft tissues, such as in the breast and muscle, though this is quite uncommon even in endemic areas.

Presentation of cases: A. A 31 year-old woman complained of a gradual progressive, painless lump in the left axillary tail of spence for two years. Examination revealed a firm lump measuring 5cm × 5cm, non-mobile, in the left axillary tail of Spence. B. A 32 year-old woman presented with mild and continuous pain in lateral aspect of left thigh. On examination, there was a round, non-tender, non-mobile mass in the lateral aspect of her left thigh. Preoperative imaging studies in both patients revealed evidence of HD. Both of the patients underwent surgery and received Albendazole twice per day for 10 days, before and three months after surgery.

Discussion: The disease can be diagnosed by serological and radiological modalities, both of which are not definitive. Ultrasonography should be the first diagnostic modality of soft tissue HD, however, MRI can be used to understand clearly the surgical involvements of structures. The standard treatment of soft tissue HD is surgery using pericystectomy techniques, as well as anthelmintic therapy.

Conclusion: HD should be suggestive in soft tissues if mass is slowly developing and presenting with local extension, particularly in endemic countries. Excision of HD using pericystectomy technique is the first choice of intervention for HD of soft tissues.