LETTER TO THE EDITOR
|Year : 2015 | Volume
| Issue : 2 | Page : 99
Primary hydatid cyst of fronto-temporo-zygomatic region: A rare presentation
Lukesh A Patil, Ashok K Laddha, Shashi S Sharma, Brajesh K Lahoti
Department of Surgery, Devision of Pediatric Surgery, Mahatma Gandhi Memorial Medical College and Maharaja Yeshwantrao Hospital, Indore, Madhya Pradesh, India
|Date of Web Publication||17-Feb-2015|
Dr. Lukesh A Patil
Room No. 31, P G Block, Mahatma Gandhi Memorial Medical College Boys Hostel, White Church Colony, Indore - 452 001, Madhya Pradesh
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Patil LA, Laddha AK, Sharma SS, Lahoti BK. Primary hydatid cyst of fronto-temporo-zygomatic region: A rare presentation. J Indian Assoc Pediatr Surg 2015;20:99
|How to cite this URL:|
Patil LA, Laddha AK, Sharma SS, Lahoti BK. Primary hydatid cyst of fronto-temporo-zygomatic region: A rare presentation. J Indian Assoc Pediatr Surg [serial online] 2015 [cited 2019 Nov 13];20:99. Available from: http://www.jiaps.com/text.asp?2015/20/2/99/151562
Primary hydatid cyst of head and neck region is a rare presentation even in the geographical areas known to be endemic for echinococcosis.  Only a few cases of primary hydatid cyst located in head and neck region have been reported. Therefore, in this case, we wish to draw attention to possibility of the hydatid disease in the specific region.
An 8-year-old male came to pediatric surgery department of our institution with 3-year history of a slowly growing fronto-temporal mass that was painless and without fever [Figure 1]. Clinical examination revealed 8 × 6 × 4 cm round swelling to be cystic and fluctuant with no local inflammatory response. Physical and neurological examinations revealed no abnormalities. Computed tomography (CT) scan showed a cyst in the left temporal region, measuring 6.1 × 7 × 3.9 cm in size. The cystic lesion was round and well-delineated by a thin wall. As the past history was unremarkable and findings were suggestive of cystic lesion, it was thought to be a benign cyst. Possibility of cystic hygroma was ruled out as the lesion appeared at the age of 8 year and was absent at the time of birth. The cyst was removed surgically intact through a lateral approach. In histopathology, there was a single globular cyst measuring 6 × 5.5 × 4 cm in diameter. On sectioning, the cyst was unilocular, filled with white gelatinous membrane. Wall thickness was 0.2 cm microscopic examination demonstrated a unicellular hyalinized lamellated layer of ectocyst with fibrous outer layer. Marked foreign body type giant cell reaction was also seen confirming hydatid cyst. Ultrasonography of the abdomen was done to know status of other visceral organs but it did not reveal any other organ involvement by the disease process. Patient was given medical treatment with albendazole (200 mg/d) for 6 weeks.
|Figure 1: Picture of the patient with visible swelling on left temporal region with streching of the lateral canthus of left eye|
Click here to view
The outcome was good, and patient remained asymptomatic for the follow-up period of 2 month.
Soft tissue hydatid disease represents less than 3% of all hydatid disease.  Hydatid disease in extracranial region is rare, with only a few cases reported in the literature. Hydatid cysts are usually not considered in the differential diagnosis of head and neck cystic swellings, especially in non-endemic areas in the absence of hydatid disease elsewhere in the body.  The rarity of the disease in this anatomical location presents a diagnostic difficulty for the physician if he or she is not familiar with the disease.
Our patient did not have any evidence of hydatid disease elsewhere in the body, neither at the time of presentation nor on post-operative diagnostic imaging. These symptoms are characteristic of any slow-growing benign tumor in the body.
The case is a reminder that although rare in head and neck, clinicians has to bear in mind hydatid cyst in the differential diagnosis of extracranial swellings especially in countries where echinococcus infestation is endemic.
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