A minimally invasive treatment option in primary muscular hydatid cyst: report of 2 cases.

A 37-year-old woman was admitted to our hospital. According to the patient, her symptoms had existed for 3 months. On physical examination, a well-circumscribed, soft, semimobile mass 10 × 8 cm in diameter was palpable on the left posterior thigh. Laboratory findings were within normal ranges, except that the indirect hemagglutination test for echinococcosis showed a titre of 1:1200. A titre > 1:320 is considered a positive result in this method. MRI revealed a multiloculated cystic mass measuring 10 × 16 × 10 cm on the left thigh that reached to the medial part of the head of the biceps femoris muscle (Fig. 1). Thoraco-abdominopelvic CT revealed no other abnormal findings. In the treatment procedure, we initially made a 5-cm vertical skin incision and reached the pericystic wall. Then, the cystic cavity was irrigated for 10 minutes with a scolicidal agent (1.5% cetrimide–0.15% chlorhexidine [10% Savlon]) to prevent possible muscle contamination after the aspiration of the clear fluid. After irrigation, a partially pericystectomy and cyst drainage was performed. Histopathological examination supported a diagnosis of cystic hydatid disease. After an uneventful recovery, the patient was treated with an average dosage of 10–12 mg/kg-1/day-1 of albendazole for 3 months, which might have contributed to preventing recurrence, as reported by the Bulletin of the WHO working group.