Ghanem Muhammad, Al Kazzaz Mohamad Zuheir, Soliman Alnour
Department of General Surgery, Damascus University, Damascus, Syria.
Department of General Surgery, Al-Mouwasat Hospital, Damascus University, Damascus, Syria.
Int J Surg Case Rep. 2021 Aug;85:106274. doi: 10.1016/j.ijscr.2021.106274. Epub 2021 Aug 4.
Hydatid cyst disease or hydatidosis is an old parasitic disease. Humans represent an accidental intermediate host. Neck is considered a rare location of hydatid cysts. It is usually overlooked as a deferential diagnosis in any cystic lesion in the neck, even in the regions where the disease is considered endemic.
A 26 year old female was admitted to Al-Mouwasat Hospital with the complaint of an anterior cervical mass causing compressive symptoms. Examinations determined a big cystic lesion at expense of the thyroid gland and extended to the level of aortic arch, in addition to smaller lesions in the two thyroid lobes. Multinodular goiter was diagnosed. However, Hydatid cyst disease was suspected during surgery. Cystectomy and total thyroidectomy were performed. Histopathology confirmed the diagnosis of hydatid cyst disease.
Hydatid cyst disease in the neck is usually asymptomatic unless it compresses near structures. Histopathological study makes the definitive diagnoses. The best treatment of thyroid hydatid cysts is total surgical excision of all cysts with intensive care not to spread the disease.
Hydatid cyst disease in the neck is extremely rare. Hydatid cyst should be included in differential diagnosis of cystic lesions in the neck especially in patients from endemic countries. Post-operative surveillance is important to diagnose the complete healing or recurrence of hydatid disease in operated or other locations but also for follow up of replacement therapy after total thyroidectomy as the patient require lifelong thyroid hormone replacement.
包虫囊肿病或包虫病是一种古老的寄生虫病。人类是偶然的中间宿主。颈部被认为是包虫囊肿的罕见部位。在颈部任何囊性病变的鉴别诊断中,它通常被忽视,即使在该病被认为是地方病的地区也是如此。
一名26岁女性因颈前肿物伴有压迫症状入住穆瓦萨特医院。检查发现一个大的囊性病变累及甲状腺,并延伸至主动脉弓水平,此外两个甲状腺叶还有较小的病变。诊断为多结节性甲状腺肿。然而,手术期间怀疑为包虫囊肿病。进行了囊肿切除术和全甲状腺切除术。组织病理学证实了包虫囊肿病的诊断。
颈部包虫囊肿病通常无症状,除非压迫附近结构。组织病理学研究可做出明确诊断。甲状腺包虫囊肿的最佳治疗方法是手术完全切除所有囊肿,并给予精心护理以防止疾病传播。
颈部包虫囊肿病极为罕见。颈部囊性病变的鉴别诊断应包括包虫囊肿,特别是来自地方病国家的患者。术后监测对于诊断手术部位或其他部位包虫病的完全愈合或复发很重要,同时对于全甲状腺切除术后替代治疗的随访也很重要,因为患者需要终身甲状腺激素替代治疗。