A Rare Presentation of Hydatid Cyst: A Case with Radial Bone Involvement

Abstract

our case was pain that was mechanical in nature. Among 16 cyst hydatid cases with bone involvement that was reported by Booz (5) in Kuwait, pathological fracture was determined as the first symptom in 9 cases (56%). Only one cyst hydatid case has been reported in literature with radial involvement similar to our case. In this case, there was involvement in lower one-third of radius. The patient applied to us complaining from local pain as in our case (6). For diagnosis, a synthesis of clinical findings, laboratory tests and radiological examinations is required, along with medical history. Surgical excision and histopathological examination are required for definitive diagnosis (6). Tuberculosis osteomyelitis, fibrous dysplasia, simple bone cyst and bone tumors should be considered in differential diagnosis. Direct radiographic examination did not give specific results. Computed tomography and magnetic resonance imaging methods are more beneficial (2,3). It was observed that the sensitivity of serological methods was between 25%-56% for bone involvement. No high values were determined in the serological tests of our patient for cyst hydatid diagnosis. Preoperative diagnosis could be determined in only two cases of the four operated bone hydatidosis cases reported by Booz (5). Diagnosis was determined with postoperative biopsy in our case. Surgical treatment alone in hydatid bone cysts may not be successful due to the difficulty of total excision, and it may increase the risk of spreading. For this reason, albendazole treatment (one course before the operation and six courses after the operation) is more successful (2). The mentioned preoperative and postoperative protocol was applied in our case, and the patient is still under follow-up. In conclusion, while hydatid bone cysts are rare, they should be included in differential diagnosis in patients applying with treatment resistant musculoskeletal pain.