Inoperable Primary Hydatidosis of Pelvic Bones with Involvement of Gluteal Muscles: Diagnosis of a Rare Presentation and Follow-up

Abstract

Primary hydatid cysts typically occur in the lungs or the liver, but can be found elsewhere without involving these organs. Primary bone cysts are rare and frequently missed. No standard treatment exists, especially for inoperable patients. A 53-year-old female patient with pain and swelling in the left gluteal region for a month was first admitted 3 years ago, with an initial diagnosis of DVT. Incidentally, magnetic resonance imaging showed cystic involvement of the pelvis, and an iliac bone biopsy suggested a diagnosis of hydatidosis. The cyst was inoperable, and praziquantel and albendazole chemotherapy was initiated. The patient was followed after 3 years, having a palpable 12 × 9 cm mass and showing minor radiographic changes. We report an unusual and inoperable case of primary bone hydatid cyst, with involvement of pelvic bones and surrounding soft tissue. This case suggests that cystic mass, especially where disease is endemic, should raise suspicion of echinococcosis. The chemotherapy regimen appears to have limited the growth of the cysts.