Sing Prem, Mushtaq Deeba, Verma Neetu, Mahajan N C
Department of Pathology, MM Institute of Medical Sciences and Research, Mullana (Ambala), Haryana 133203, India.
Korean J Parasitol. 2010 Sep;48(3):263-5. doi: 10.3347/kjp.2010.48.3.263. Epub 2010 Sep 16.
Echinococcosis is a multisystem disease and has propensity to involve any organ, an unusual anatomical site, and can mimic any disease process. Primary peritoneal echinococcosis is known to occur secondary to hepatic involvement but occasional cases of primary peritoneal hydatid disease including pelvic involvement have also been reported. We report here 1 such case of primary pelvic hydatidosis mimicking a malignant multicystic ovarian tumor where there was no evidence of involvement of the liver or spleen. Our patient, a 27-year-old female, was detected to have a large right cystic adnexal mass on per vaginal examination which was confirmed by ultrasonography. Her biochemical parameters were normal and CA-125 levels, though mildly raised, were below the cut off point. She underwent surgery and on exploratory laparotomy, another cystic mass was found attached to the mesentery of the small gut. The resected cysts were processed histopathologically. On cut sections both large cysts revealed numerous daughter cysts. Microscopic examination of fluid from the cysts revealed free scolices with hooklets and the cyst wall had a typical laminated membrane with inner germinal layer containing degenerated protoplasmic mass. The diagnosis of pelvic hydatid disease was confirmed and patient was managed accordingly. Hydatid disease must be considered while making the differential diagnosis of pelvic cystic masses, especially in endemic areas.
棘球蚴病是一种多系统疾病，易累及任何器官、不常见的解剖部位，并可模拟任何疾病过程。原发性腹膜棘球蚴病已知继发于肝脏受累，但也有原发性腹膜包虫病（包括盆腔受累）的偶发病例报道。我们在此报告1例原发性盆腔包虫病，其表现类似恶性多囊性卵巢肿瘤，且无肝脏或脾脏受累的证据。我们的患者为一名27岁女性，经阴道检查发现右侧附件有一个巨大的囊性肿块，超声检查证实了这一情况。她的生化指标正常，CA - 125水平虽略有升高，但低于临界值。她接受了手术，在剖腹探查时，发现另一个囊性肿块附着于小肠系膜。对切除的囊肿进行了组织病理学处理。在切片上，两个大囊肿都显示出许多子囊。对囊肿液的显微镜检查发现有带小钩的游离头节，囊肿壁有典型的板层膜，内部生发层含有退化的原生质团。盆腔包虫病的诊断得到证实，并对患者进行了相应的治疗。在对盆腔囊性肿块进行鉴别诊断时，尤其是在流行地区，必须考虑到包虫病。
