Gougoulias N E, Varitimidis S E, Bargiotas K A, Dovas T N, Karydakis G, Dailiana Z H
Hippokratia. 2010 Apr;14(2):126-30.
Muscle hydatidosis is rare, accounting only for 3-5% of all cases. We present a case series of 9 patients (8 male, one female, mean age 59.3 years, range 48-75 years) with primary echinococcosis of skeletal muscles. The cysts presented as soft tissue masses in 8 patients, whereas in one, the cyst was an incidental finding on a CT scan performed for investigation of a lung problem. All hydatid cysts were confined into muscles, without affecting the bone. The location was the thigh region in 6 patients (quadriceps in 4, biceps in 2), the popliteal fossa (gastrocnemius) in one, the humerus (triceps branchii) in one and the shoulder (infraspinatus) in one patient. MRI showed multi-vesicular cysts in all patients. Indirect hemagglutination serological test was positive in 6 out of 9 cases. En block surgical excision of the cysts was undertaken in all patients. Two patients received antihelminthic chemotherapy preoperatively. Histopathologic findings confirmed the diagnosis. No recurrence occurred during the follow-up period (1-8 years). Skeletal muscle echinococcosis should be considered in the differential diagnosis of limb masses, especially in endemic countries. A meticulous history taking and MRI imaging are essential, while pericystectomy is an effective method of treatment.
肌肉包虫病较为罕见，仅占所有病例的3%至5%。我们报告了一组9例原发性骨骼肌棘球蚴病患者（8例男性，1例女性，平均年龄59.3岁，范围48至75岁）。8例患者的囊肿表现为软组织肿块，而1例患者的囊肿是在因肺部问题进行CT扫描时偶然发现的。所有包虫囊肿均局限于肌肉内，未累及骨骼。6例患者的病变位于大腿区域（4例股四头肌，2例肱二头肌），1例位于腘窝（腓肠肌），1例位于肱骨（肱三头肌分支），1例位于肩部（冈下肌）。所有患者的MRI均显示为多囊性囊肿。9例中有6例间接血凝血清学试验呈阳性。所有患者均接受了囊肿整块手术切除。2例患者术前接受了抗蠕虫化疗。组织病理学检查结果确诊。随访期间（1至8年）未发生复发。在肢体肿块的鉴别诊断中应考虑骨骼肌棘球蚴病，尤其是在流行地区。详细的病史采集和MRI成像至关重要，而囊肿切除术是一种有效的治疗方法。
