Al-Hakkak Samer Makki Mohamed
Faculty of Medicine, Department of Surgery, Jabir Ibn Hayyan Medical University, Iraq.
Int J Surg Case Rep. 2018;49:140-144. doi: 10.1016/j.ijscr.2018.06.002. Epub 2018 Jun 30.
Hydatid cyst (HC) disease is a serious health problem in endemic areas, solitary primary subcutaneous hydatid cyst is not frequent and the only symptom is generally a silent growing mass. Total excision remains the mainstay of treatment. The aim of the study was to present a case surgically treated.
48-year-old female farmer presented with HC of the right hypochondrium who was managed surgically.
The mechanism of primary subcutaneous localization is unclear. There are two potential mechanisms; (a) direct subcutaneous contamination through an injured skin or (b) subcutaneous colonization of ingested eggs after passing liver and lungs. I believe that subcutaneous colonization of the parasite in the circulation after ingestion is an only reliable mechanism than the other contact theory, because of the cases in literature occur without any direct contamination.
Primary subcutaneous hydatid cyst must always be considered in the differential diagnosis of silent growing mass in soft tissues or subcutaneous. History and physically associated with ultrasound and magnetic resonance imaging are sufficient to achieve a correct preoperative diagnosis.
包虫囊肿（HC）病在流行地区是一个严重的健康问题，孤立的原发性皮下包虫囊肿并不常见，通常唯一的症状是一个无声生长的肿块。完整切除仍然是主要的治疗方法。本研究的目的是介绍一例手术治疗的病例。
一名48岁的女性农民因右季肋部包虫囊肿接受手术治疗。
原发性皮下定位的机制尚不清楚。有两种潜在机制：（a）通过受损皮肤直接皮下污染，或（b）摄入的虫卵在经过肝脏和肺部后在皮下定植。我认为，摄入后寄生虫在循环系统中的皮下定植是比其他接触理论更可靠的唯一机制，因为文献中的病例发生时没有任何直接污染。
在软组织或皮下无声生长肿块的鉴别诊断中，必须始终考虑原发性皮下包虫囊肿。病史以及结合超声和磁共振成像的体格检查足以实现正确的术前诊断。
