Unusual localizations of human hydatid disease in Hamedan province, west of Iran

Cystic echinococcosis (CE) is endemic in many parts of Iran. It may develop in almost any part of the human body, though the location is mostly hepatic and followed by pulmonary. This study was carried out on the 24 patients diagnosed with unusual localizations of hydatidosis among the patients admitted to the university hospitals in Hamedan province, west of Iran, during 14-year period. The cases were aged 6 – 73 years, the majority being aged 40 – 59 years (33.3 %). Ten of the patients diagnosed with unusually located hydatid disease were men, fourteen were women. The over-representation of housewives (50.0 %) and followed by farmers (20.8 %) among the cases was significant. Similarly, rural dwellers were also over-represented among the cases (54.2 % vs. 45.8 %).

Most (19 case) of the cases had been diagnosed just by ultrasonography, but 3 case had only been diagnosed by computed tomographic (CT) scans, and another 2 had had both ultrasonography and CT scans. Spleen and kidneys, followed by abdominal/peritoneal cavity, were the organs where hydatid disease was most frequently observed after the liver and lung. The splenic cysts were solitary in 4 cases, associated with a hepatic cyst in 1 and with pelvic and abdominal wall cysts in 1. The renal cysts were usually isolated without any other organ involvement, and there was only one case of associated with hydatid disease in liver. In addition, findings in brain, mesenterium, breast, choledochus, bladder wall and inguinal area are also discussed.

These results confirm that CE should be considered in the differential diagnosis of any cystic mass in all anatomic locations (including unusual localizations), especially when occurring in areas where the disease is endemic.