Exploring Rare locations of Hydatid Disease: Beyond the Usual Suspects

INTRODUCTION: Hydatid disease, endemic in Mediterranean countries, predominantly affects the liver, but its presence can extend throughout the human body. Non-hepatic and non-pulmonary cysts often pose diagnostic complexities. This study delves into this matter, examining patients with hydatid cysts located in atypical areas. OBSERVATION: From 2013 to 2020, our center treated 250 patients with echinococcosis. Among them, 11 cases (4.4%) of hydatid disease in uncommon sites were retrospectively reviewed. Among these 11 patients (5 males, 6 females), a distinctive distribution of unusual cyst locations was observed. Of note, 6 patients exhibited exclusively extrahepatic cysts. The most recurrent extrahepatic sites were the peritoneal cavity and spleen: 6 patients displayed splenic hydatid cysts, either in isolation or combined with peritoneal cysts. Moreover, 3 patients presented with pelvic cysts: one between the rectum and urinary bladder, another in the Douglas region, and the third situated in the rectovaginal septum. In addition, 1 patient had a gluteal cyst, and the final patient was affected by a cyst within the spermatic cord. CONCLUSION: Diagnosing hydatid cysts in uncommon locations is a formidable challenge. Surgeons should always contemplate the prospect of an unconventional cyst location when encountering patients with cystic masses in endemic regions. Failing to consider this possibility could lead to unfavorable outcomes.