1. Authors: Dr. Shubh Narayan Ghanghoriya, Dr. Manoj Kela (HOD & PROF.)
(
Affiliations: Department Of General Surgery, Sri Aurobindo Institute of Medical Sciences
AN INTERESTING CASE OF LEG SWELLING WITH
MULTIPLE DISCHARGING SINUSES
Introduction
• Intramuscular hydatid
cysts:
Hydatid cysts are rarely
detected in the muscle
tissue, even in endemic
countries. Echinococcus
granulosis is the most
common causative agent,
whereas Echinococcus
alveolaris is rare
•MRI : Evidence of a
loculated thick walled
pocket of collection noted
in mid leg region in
muscular compartment
(involving tibialis
posterior, flexor hallucis
longus) with associated
surrounding edema /
myositis.
•SURGICAL M/M :
Incision with drainage
with pericystectomy
was chosen as the
preferred surgical
treatment.
Primary muscular HC
is a rare entity.
However, several
cases of isolated cyst
have been reported in
upper and lower
proximal muscles.
To our knowledge, no
reports of multiple HC
in the muscle have
been documented.
Differential Diagnosis :
• Lipoma,
• Actinomycetes
• Calcified hematoma,
• Cold abscess or
• Soft tissue tumour.
• Musculoskeletal
echinococcosis should
always be suspected in
patients from endemic
regions
Case Report
Hospital Course
Discussion
11. Safioleas M, Nikiteas N, Stamatakos M, Safioleas C, Manti CH, Revenas C,et al. Echinococcal cyst of the subcutaneous tissue: a rare
case report.Parasitol Int 2008; 57: 236-8. [CrossRef]
2. Duzgun N, Esme H, Duran F. M, Calik M, Cetin, B. Hydatid Disease of the Spine: Case Report Turkiye Klinikleri Arch Lung 2014; 15: 79-
82
3. Ormeci N, Idilman R, Akyar S, Palabiyikoğlu M, Coban S, Erdem H, et al. Hydatid cysts in muscle: a modified percutaneous treatment
approach.Int J Infect Dis 2007; 11: 204-8. [CrossRef]
References
29 y/o male patient
came to surgery OPD
on 30/5/22 with
complaints of pain and
swelling on the lateral
aspect of right lower
leg since 1 month with
a discharging sinus
since 8 days.
Clinically,
Mild tenderness with
Signs of inflammation
were present over calf
region.
Discharging sinus present
over the right leg lateral
aspect of size
approximately 2x2 cms
about 13 cms above the
lateral malleolus.
X-ray shows no bony
involvement.
Treatment involved
400 mg of
albendazole per day
for 15 days before
and three weeks
after surgery.
USG shows multiple well-
defined anechoic round
cystic lesions