An unusual case: Ruptured and infected primary muscle cystic echinococcosis

Abstract

There are few case reports of primary muscle cystic echinococcosis in which a hot abscess developed at the site of the cyst following its perforation. Here, the author presents a 23-year-old female with a hydatid cyst of more than 15 years’ duration in her right quadriceps muscle. The cyst did not cause any complaints for years and grew very slowly, but eventually became infected and perforated. A large hot abscess was formed at its site. The patient was managed successfully by surgical and medical treatments. She was assessed carefully for clinical, radiological, surgical and histopathological findings. Investigations were made to differentiate the condition from classical hot abscesses and other soft tissue masses. In T1-and T2-weighted magnetic resonance images, a hypointense membranous structure (the perforated rim) within the mass of the lesion was significant for its differential diagnosis. In conclusion, especially in endemic regions, magnetic resonance imaging is a valuable tool in differentiating soft tissue cystic echinococcosis in the presence of infected and rapidly enlarging masses after long periods of dormancy.