Subcutaneous hydatid cyst in the popliteal fossa at the site of a previous wasp sting

Department of Radiology, Medical University of Pécs, Pécs, Hungary.
Diagnostic and interventional radiology (Ankara, Turkey) (Impact Factor: 1.43). 02/2010; 17(2):163-5. DOI: 10.4261/1305-3825.DIR.2933-09.1
Source: PubMed


We report an uncommon case of a primary Echinococcus cyst that developed in the subcutaneous tissue of the right popliteal fossa, at the spot of a previous wasp sting, suggesting the possibility of an unusual transmission of the eggs by insects. This unusual presentation was initially considered as a Baker cyst until parasytological results verified Echinococcus hydatidosus, the larval form of Echinococcus granulosus, as diagnosis. However, the most common path of Echinococcus granulosus infection is through contact with a definitive host or by ingestion of ova through contaminated water or food. Transmission by insects should also be reconsidered in endemic areas.

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Available from: István Battyány,
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    • "Subcutaneous surgery in case of parasitic cyst does not show any postoperative complications and if the lesion is properly removed, relapses will be observed very rarely [9]. "
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    ABSTRACT: Solitary subcutaneous hydatid cyst is not frequent and the only symptom is generally a silent growing mass. Total excision remains the mainstay of treatment. Aim of the study was to present a case surgically treated and perform a statistical analysis reviewing previous published works in order to define a correct approach to diagnosis and treatment. 264 documents from Medline database were considered for primary subcutaneous hydatid cyst cases. Data concerning geographic region, gender, age, job, location, evolving time, history and physical, mobility, diameter, laboratory, imaging, locularity (uni- or multilocular cyst), fine-needle aspiration, preoperative diagnosis, neoadjuvant chemotherapy, treatment, spillage, adjuvant therapy, follow-up and recurrences were ordered in a database and analysed performing T-test, Fisher's test and Pearson's test. 23 cases, included ours, resulted suitable for our study. Lower extremities were involved in most cases (60.9%) and the thigh represented the most common site (34.8%), whereas upper extremities were the rarest location (8.7%). Patients with head and neck located cysts were younger than those with upper extremities cysts (P = 0.037). Patients who underwent multiple imaging approach received a significantly correct first diagnosis (P = 0.001) and ultrasonography, unlike other techniques, appeared to be essential (P = 0.013). A 68-year-old man who lived and worked in his farm in Sicily (Italy) presented with a 30-year-growing mass in the deltoid region measuring 10 cm. Ultrasonography and magnetic resonance imaging strongly suggested hydatid cyst. Therefore the cyst was excised and pathology confirmed the diagnosis. Solitary subcutaneous hydatid cyst must always be considered in the differential diagnosis of silent growing mass in soft tissues. History and physical associated with ultrasound and magnetic resonance imaging are sufficient to achieve a correct preoperative diagnosis.
    Parasitology International 07/2013; 62(6). DOI:10.1016/j.parint.2013.06.013 · 1.86 Impact Factor
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    • "This was the 11th U.S case in about 50 reported worldwide (Wilson and others 2001). Battyany and others (2011) described a case of Hydatid cyst following a wasp sting, opening the question of potential transmission through this kind of vector, mainly in endemic areas. No other studies have focused on this topic. "
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    ABSTRACT: ?Increasing world population worsens the serious problem of food security in developing countries. On the other hand in industrialized countries, where the problem of food security is of minor concern, health problems related to food refer to 2 main factors: food safety and environmental sustainability of food production. For these reasons, new ways must be found to increase yields while preserving food quality, natural habitats, and biodiversity. Insects could be of great interest as a possible solution due to their capability to satisfy 2 different requirements: (i) they are an important source of protein and other nutrients; (ii) their use as food has ecological advantages over conventional meat and, in the long run, economic benefits. However, little is known on the food safety side and this can be of critical importance to meet society's approval, especially if people are not accustomed to eating insects. This paper aims to collect information in order to evaluate how insects could be safely used as food and to discuss nutritional data to justify why insect food sources can no longer be neglected. Legislative issues will also be discussed.
    05/2013; 12(3):296-313. DOI:10.1111/1541-4337.12014
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    • "Negative 4x5 Primary Retroperitoneal ? Positive 15x15 Battyany I et al 2011 [6] "
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    ABSTRACT: Objective: Hydatic cyst is a parasitic disease caused by the larvae of Echinococcus granulosus. In the study, the aim is to evaluate the relation between serology and grow-up time in atypically localized cysts. Methods: Retrospectively, all the patients with hydatic disease between December 2004 and May 2012 were screened from the hospital database. Hydatic cyst localization other than the liver and lungs were accepted as atypical localization. Results: There were 325 patients with a diagnosis of hydatic disease. Most common localizations of the cysts were the liver (72.8%) and lungs (21%). Atypically localized cyst rate was 6.4% (n: 21). The most common atypical localization was the spleen (2.4%). 80.9% of atypically localized cysts were primary cases. In 3 cases with primary intramuscular hydatic cyst and 2 cases with primary subcutaneous hydatic cysts, serology was negative. Conclusion: The relation between the hydatid cyst and the host is the main factor in serological tests and grow-up time. In tissues with a weaker cellular immunity like muscle and subcutaneous tissue, serology tends to be negative and grow-up time to be faster. In atypically localized cysts,hematogenous dissemination cannot explain the pathogenesis fully. Therefore, lymphatic dissemination should be kept in mind.
    Turkiye parazitolojii dergisi / Turkiye Parazitoloji Dernegi = Acta parasitologica Turcica / Turkish Society for Parasitology 01/2013; 37(4):257-261. DOI:10.5152/tpd.2013.3056
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