Inonu University, Department of General Surgery, Malatya, Turkey.
Int J Surg. 2011;9(2):117-21. doi: 10.1016/j.ijsu.2010.10.009. Epub 2010 Oct 25.
We aimed to review cases of primary subcutaneous hydatid cysts whether this is a fearsome disease or a benign progressed pathology. These cysts are rare, have difficulty in diagnosis and management, particularly for inexperienced clinicians.
We searched key words of "echinococcosis, hydatid, soft tissue, subcutaneous, cutaneous" at MEDLINE/PUBMED. We eliminated unrelated articles, cases with primary visceral hydatid focus or muscular cysts. Twenty publications including 22 patients were suitable for analysis. We contacted with authors of the articles for missing data. Follow-up periods and recurrences were updated.
All patients were from endemic areas and most from rural regions (90%). Most frequent locations were thigh (27%) and gluteal region (9%). Mean size was 5.7 + 3.1 cm (2-15 cm). Main symptom (70%) was painless, slow growing mass with normal overlying skin. Serologic tests were usually negative (79%). Only 45% of the patients were diagnosed as hydatid cyst before treatment. Most cases (91%) were treated by surgical excision and spillage occurred at 25% of them. Cyst pouchs were irrigated with protoscolocidal solutions after cyst removal. There was no anaphylaxis during procedures. There was no recurrence with a mean follow-up of 26 + 18 months (6-60 months).
Primary subcutaneous hydatid cyst should be in mind for differential diagnosis of soft tissue masses particularly for patients who lived in regions where hydatid cyst is endemic. There is no reported anaphylaxis or recurrence during diagnostic or therapeutic interventions. Complete excision is the best treatment option. Primary subcutaneous hydatid cysts generally look like a benign progressed disease.
我们旨在回顾原发性皮下包虫囊肿病例，以明确其究竟是一种可怕的疾病还是良性进展性病变。这些囊肿较为罕见，诊断和处理困难，尤其是对经验不足的临床医生而言。
我们在 MEDLINE/PUBMED 上搜索了“包虫病、包虫、软组织、皮下、皮肤”等关键词。我们排除了不相关的文章、原发性内脏包虫病灶或肌肉囊肿的病例。共有 20 篇文献包括 22 例患者适合进行分析。我们与文章的作者联系以获取缺失的数据。更新了随访时间和复发情况。
所有患者均来自流行地区，且大多来自农村地区（90%）。最常见的部位是大腿（27%）和臀部（9%）。平均大小为 5.7 + 3.1cm（2-15cm）。主要症状（70%）为无痛、缓慢生长的肿块，伴有正常的皮肤覆盖。血清学检测通常为阴性（79%）。只有 45%的患者在治疗前被诊断为包虫囊肿。大多数病例（91%）采用手术切除治疗，其中 25%的病例发生囊肿溢漏。在切除囊肿后，用杀原头节溶液冲洗囊袋。手术过程中无过敏反应。平均随访 26 + 18 个月（6-60 个月）后无复发。
对于软组织肿块的鉴别诊断，特别是对于生活在包虫病流行地区的患者，应考虑原发性皮下包虫囊肿。在诊断或治疗干预过程中，均无过敏或复发的报道。完整切除是最佳治疗选择。原发性皮下包虫囊肿通常表现为良性进展性疾病。
