Samsami Majid, Qaderi Shohra, Zebarjadi Bagherpour Javad, Lucero-Prisno Don Eliseo
Department of General Surgery, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Int J Surg Case Rep. 2021 Feb;79:475-478. doi: 10.1016/j.ijscr.2021.01.087. Epub 2021 Jan 29.
Hydatid Disease (HD), or hydatidosis or echinococcosis, is an endemic infection and a major public health concern in the Mediterranean region. At times it involves the primary soft tissues, such as in the breast and muscle, though this is quite uncommon even in endemic areas.
A. A 31 year-old woman complained of a gradual progressive, painless lump in the left axillary tail of spence for two years. Examination revealed a firm lump measuring 5cm × 5cm, non-mobile, in the left axillary tail of Spence. B. A 32 year-old woman presented with mild and continuous pain in lateral aspect of left thigh. On examination, there was a round, non-tender, non-mobile mass in the lateral aspect of her left thigh. Preoperative imaging studies in both patients revealed evidence of HD. Both of the patients underwent surgery and received Albendazole twice per day for 10 days, before and three months after surgery.
The disease can be diagnosed by serological and radiological modalities, both of which are not definitive. Ultrasonography should be the first diagnostic modality of soft tissue HD, however, MRI can be used to understand clearly the surgical involvements of structures. The standard treatment of soft tissue HD is surgery using pericystectomy techniques, as well as anthelmintic therapy.
HD should be suggestive in soft tissues if mass is slowly developing and presenting with local extension, particularly in endemic countries. Excision of HD using pericystectomy technique is the first choice of intervention for HD of soft tissues.
包虫病（HD），又称包虫感染或棘球蚴病，是一种在地中海地区流行的感染性疾病，也是主要的公共卫生问题。有时它会累及原发性软组织，如乳房和肌肉，不过即便在流行地区这种情况也相当罕见。
A. 一名31岁女性主诉左乳腺外上象限腋窝尾部有一个逐渐增大的无痛性肿块，持续两年。检查发现左乳腺外上象限腋窝尾部有一个5厘米×5厘米的质地坚硬、不可移动的肿块。B. 一名32岁女性表现为左大腿外侧轻度持续疼痛。检查时，在其左大腿外侧发现一个圆形、无压痛、不可移动的肿块。两名患者术前影像学检查均显示有包虫病迹象。两名患者均接受了手术，并在手术前及术后三个月每天服用两次阿苯达唑，共10天。
该疾病可通过血清学和影像学方法进行诊断，但两者都不具有决定性。超声检查应是软组织包虫病的首选诊断方法，不过磁共振成像（MRI）可用于清楚了解结构的手术累及情况。软组织包虫病的标准治疗方法是采用囊肿外切除术技术进行手术，以及驱虫治疗。
如果软组织中出现缓慢发展并伴有局部扩展的肿块，尤其是在流行国家，应怀疑为包虫病。采用囊肿外切除术技术切除包虫病是软组织包虫病干预的首选方法。
