Zairi Mohamed, Boussetta Rim, Msakni Ahmed, Sahraoui Ghada, Mohseni Ahmed Amin, Nessib Mohamed Nabil
Faculty of Medicine of Tunis, Department of Pediatric Orthopedic Surgery, Bechir Hamza Children's Hospital, Tunis, Tunisia.
Faculty of Medicine of Tunis, Department of Pediatric Orthopedic Surgery, Bechir Hamza Children's Hospital, Tunis, Tunisia.
Int J Surg Case Rep. 2021 Dec;89:106570. doi: 10.1016/j.ijscr.2021.106570. Epub 2021 Nov 3.
Most of the time, intramuscular hydatid cysts are secondary. The unusual topographies are a source of diagnostic delay and treatment difficulties. The aim of our case report is to put forward the features of this uncommon presentation and to propose a therapeutic management.
We report the case of a primary hydatid cyst located in the right lumbar paraspinal muscles in a ten-year-old girl, in good health and without a pathological medical history. The patient presented with a discreet right lumbar swelling of firm consistency, painless and without signs of inflammation. Ultrasound and magnetic resonance imaging suggested the diagnosis of an intramuscular paravertebral hydatid cyst. The hydatid serology was positive. The patient had en-bloc resection of the cyst. He was infected with pus. The histopathological examination confirmed the diagnosis of muscular hydatidosis. Medical treatment was started. Three years after the operation, the MRI confirmed that was no recurrence.
Echinococcus is a parasitic cestode that can infect dogs and other pets and farm animals, with humans as incidental hosts. Muscular hydatid localization, secondary to hematogenous dissemination, is rare, even in endemic countries. The combination of medical treatment with surgery ensures the best condition to avoid recurrence.
In regions where hydatidosis is endemic, a tumor in any part of the body should be considered a hydatid cyst until proven otherwise.
大多数情况下，肌肉内包虫囊肿是继发性的。异常的部位是诊断延迟和治疗困难的根源。我们病例报告的目的是提出这种罕见表现的特征并提出治疗方案。
我们报告一例原发性包虫囊肿位于一名10岁健康女童右腰旁脊柱旁肌肉的病例，该女童无病史。患者出现右侧腰部轻度肿胀，质地坚硬，无痛且无炎症迹象。超声和磁共振成像提示诊断为椎旁肌肉内包虫囊肿。包虫血清学检查呈阳性。患者接受了囊肿整块切除。术中发现囊肿有脓液。组织病理学检查确诊为肌肉包虫病。开始进行药物治疗。术后三年，磁共振成像证实无复发。
棘球绦虫是一种寄生性绦虫，可感染狗及其他宠物和家畜，人类为偶然宿主。即使在流行地区，经血液传播继发的肌肉包虫定位也很罕见。药物治疗与手术相结合可确保最佳条件以避免复发。
在包虫病流行地区，在未确诊之前，身体任何部位的肿瘤都应考虑为包虫囊肿。
