An unusual tumor mimicker in the iliac wing: A hydatid cyst

A 49-year-old woman presented with left hip pain and movement limitation. Direct radiography showed a large expansile lytic lesion without cortical destruction in the left iliac wing. Magnetic resonance imaging revealed a multicystic left iliac lesion (Figure 1). Histopathologic examination revealed a hydatid cyst.

FIGURE 1:
Direct radiography (A) shows a large expansile lytic lesion (in brackets) in the left iliac wing. Magnetic resonance images (B) reveal multicystic iliac lesions (in brackets).

Hydatid cysts caused by the larval stage of Echinococcus granulosus remain an important health problem¹. The disease is primarily located in the liver and lungs; involvement of the musculoskeletal system is rare, especially bone localization, which occurs in less than 1% of cases². The spine is most commonly involved in bone structure in such cases³. The treatment of bone-located hydatid cysts is more difficult compared to other regions^2,3. Although rare, bone hydatid cyst is a clinically serious disease. Destructive growth in hydatid cysts can lead to high rates of morbidity similar to locally malignant bone tumors³. Iliac involvement is relatively rare and can mimic cystic neoplasms of the iliac bone.

REFERENCES

• ¹
  Aydin Y, Altuntas B, Kaya A, Ulas AB, Uyanık MH, Eroglu A. The Availability of Echinococcus IgG ELISA for Diagnosing Pulmonary Hydatid Cysts. Eurasian J Med. 2018;50(3):144-7.
• ²
  Aydin Y, Ulas AB, Ince I, Korkut E, Ogul H, Eren S, et al. Large Case Series Analysis of Cystic Echinococcosis. Indian J Surg. 2021;83(Suppl 4):S897-S906. Available from: https://doi.org/10.1007/s12262-021-03061-0
  » https://doi.org/10.1007/s12262-021-03061-0
• ³
  Cattaneo L, Manciulli T, Cretu CM, Giordani MT, Angheben A, Bartoloni A, et al. Cystic Echinococcosis of the Bone: A European Multicenter Study. Am J Trop Med Hyg. 2019;100(3):617-21.

• Financial Support: The authors declare that the article content was composed in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Publication Dates

• Publication in this collection
  30 Sept 2022
• Date of issue
  2022

History

• Received
  08 July 2022
• Accepted
  24 Aug 2022