Alimehmeti Ridvan, Seferi Arsen, Rroji Arben, Alimehmeti Mehdi
Department of Neurosurgery, University Hospital Center Mother Theresa, Tirana, Albania.
J Infect Dev Ctries. 2012 Jun 15;6(6):531-5. doi: 10.3855/jidc.1766.
An unusual case of saphenous neuropathy secondary to compression by a large hydatid cyst within the adductor longus muscle is reported. Solitary hydatid cyst(s) localized in the skeletal muscles occur rarely and often mimic soft tissue tumours. Presentation with signs of peripheral nerve compression by a hydatid cyst in an extremity is exceedingly rare. Diagnosis can be established by ultrasound, computerized tomography or magnetic resonance if clinically suspected. Clinical suspicion of hydatid origin of a solitary muscle cyst should be high especially in patients hailing from areas endemic for echinococcosis. Laboratory tests are usually unhelpful in such cases and needle biopsy carries the risk of anaphylactic shock and should therefore be avoided. Surgical removal of the unruptured cyst is the treatment of choice in cases of intramuscular hydatid cyst. In the present case, excision of the hydatid cyst was followed by complete clinical recovery. In the absence of systemic involvement, treatment with albendazole may be avoided.
报告了一例不寻常的病例,即长收肌内的巨大包虫囊肿压迫导致隐神经病变。孤立的包虫囊肿局限于骨骼肌很少见,且常类似软组织肿瘤。肢体的包虫囊肿出现周围神经受压体征极为罕见。如果临床怀疑,可通过超声、计算机断层扫描或磁共振成像来确诊。对于孤立性肌肉囊肿,临床高度怀疑其为包虫起源时应格外警惕,尤其是来自棘球蚴病流行地区的患者。在此类病例中,实验室检查通常无帮助,而针吸活检有发生过敏性休克的风险,因此应避免。对于肌肉内包虫囊肿,手术切除未破裂的囊肿是首选治疗方法。在本病例中,切除包虫囊肿后临床完全康复。在无全身受累的情况下,可避免使用阿苯达唑治疗。