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罕见的股部肌肉骨骼包虫囊肿困扰女性一年:病例报告

Uncommon musculoskeletal femoral hydatid cyst disturbs a female for a year: Case report.

作者信息

Zazo Aya, Zazo Rama, Shashaa Mohammad Nour, Alkarrash Mohamad Shadi, Brimo Alsaman Muhamad Zakaria, Niazi Ammar

机构信息

Faculty of Medicine, University of Aleppo, Aleppo, Syria.

General Surgery Department, Faculty of Medicine, Aleppo University Hospital, University of Aleppo, Aleppo, Syria.

出版信息

Ann Med Surg (Lond). 2020 May 11;55:30-32. doi: 10.1016/j.amsu.2020.04.025. eCollection 2020 Jul.

Abstract

"Hydatid cyst" which also known as cystic Echinococcosis is a parasitic infestation caused by the larval stage of Echinococcus granulosus. The liver and lungs are the most sites to occur. Incidence in muscles is exceptionally rare. We report a case of a 36-year-old female presented with an uncomfortable mass in the upper medial of her right thigh without any presence of other symptoms. She lived in a rural area in Manbij, which is an endemic area of hydatid cysts in Syria. She was a shepherdess; therefore she had direct contact with sheep and dogs. Ultrasound examination showed a cyst located between adductor longus muscle and gracilis muscle closed to the deep femoral artery. The patient was treated with pharmaceutical therapy for a week before cystectomy, which was done under general anesthesia. The cyst was dissected between the fibers of adductor longus muscle from the lateral side and fibers of the gracilis muscle from the medial side. The cyst with all its layers was resected. Musculoskeletal Echinococcosis is a rare disease, because of intramuscular growth of cysts is restricted by muscle's contractility, the muscles are undesirable habitat for Echinococcus granulosus and because of the hepatic barrier role. Many cysts are revealed by complications such as nerve compressions, infections simulating an acute abscess or a malignant tumor. Hydatid cyst present as mass of soft tissue, particularly in endemic areas, as a result of contaminated water. MRI considered the best technique in the diagnosis.

摘要

包虫囊肿,也称为囊性棘球蚴病,是由细粒棘球绦虫的幼虫阶段引起的寄生虫感染。肝脏和肺部是最常发病的部位。肌肉发病极为罕见。我们报告一例36岁女性病例,其右大腿内侧上部出现肿物且伴有不适,无其他任何症状。她生活在叙利亚曼比季的一个农村地区,该地区是包虫囊肿的流行区。她是一名牧羊女,因此与绵羊和狗有直接接触。超声检查显示一个囊肿位于长收肌和股薄肌之间,靠近股深动脉。患者在囊肿切除术前接受了一周的药物治疗,手术在全身麻醉下进行。从外侧在长收肌纤维之间以及从内侧在股薄肌纤维之间分离囊肿。完整切除囊肿及其所有层面。肌肉骨骼棘球蚴病是一种罕见疾病,因为囊肿在肌肉内的生长受到肌肉收缩性的限制,肌肉不是细粒棘球绦虫适宜的生存环境,还因为肝脏的屏障作用。许多囊肿是由诸如神经受压、类似急性脓肿或恶性肿瘤的感染等并发症发现的。包虫囊肿表现为软组织肿物,特别是在流行区,是由于水受到污染所致。磁共振成像被认为是诊断的最佳技术。

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