Ozsoy Mustafa, Keles Celalettın, Kahya Mumtaz, Keles Gonul
Department of General Surgery, Manisa State Hospital, Manisa, Turkey.
J Infect Dev Ctries. 2011 Nov 15;5(11):825-7. doi: 10.3855/jidc.1589.
Human hydatid disease is a parasitic infection caused by the larval form of Echinococcus granulosus. It has worldwide distribution and is endemic in many countries, especially the Mediterranean region. It most commonly affects the liver and lungs although multi-organ involvement has been observed in 20-30% of patients.
A 45-year-old woman presented to a gynaecologist because of a mass in the axillary region. Her mother and her two sisters were undergoing treatment for breast cancer. In her examination, a hard, semi-mobile, painless mass was found that was approximately 3 cm in diameter. Axillary ultrasonography showed lymphadenopathy. No abnormality was found in mammographic examination of either breast, or in abdominal ultrasonography and chest X-ray. Occult breast cancer was suspected but when the mass was excised for pathological examination the biopsy showed a hydatid cyst with germinative membranes. Subsequent lung, abdomen and brain tomography scans, whole body bone scintigraphy and hydatid serology, including indirect haemagglutination and enzyme-linked immunosorbent assay, were negative. For these reasons an isolated axillary hydatid cyst was diagnosed.
Parasitic cysts should be considered in endemic areas in patients presenting with a soft tissue mass in the axillary region. Imaging methods should be planned to include this possibility.
人类包虫病是由细粒棘球绦虫幼虫引起的寄生虫感染。该病在全球范围内均有分布，在许多国家呈地方性流行，尤其是地中海地区。虽然在20% - 30%的患者中观察到多器官受累，但它最常影响肝脏和肺部。
一名45岁女性因腋窝区肿物就诊于妇科医生。她的母亲和两个姐妹正在接受乳腺癌治疗。在检查中，发现一个坚硬、半活动、无痛的肿物，直径约3厘米。腋窝超声显示淋巴结病。双侧乳房钼靶检查、腹部超声检查和胸部X线检查均未发现异常。怀疑为隐匿性乳腺癌，但肿物切除后病理检查显示为带有生发膜的包虫囊肿。随后的肺部、腹部和脑部断层扫描、全身骨闪烁显像以及包虫血清学检查，包括间接血凝试验和酶联免疫吸附测定，均为阴性。基于这些原因，诊断为孤立性腋窝包虫囊肿。
在流行地区，对于腋窝区出现软组织肿物的患者，应考虑寄生虫囊肿的可能。影像学检查方法应规划为包含这种可能性。
