Multifaceted Approach in Diagnosing and Managing Pelvic and Hip Echinococcosis: A Case Report

Abstract

Echinococcosis, a zoonotic disease caused by Echinococcus granulosus or Echinococcus multilocularis, forms hydatid cysts in various organs, occasionally affecting the skeletal system. The present case study delves into a rare instance of pelvic and hip echinococcosis, underscoring the diagnostic and treatment challenges posed by such atypical manifestations. Hereby, the authors present a case of 42-year-old male, who presented with persistent lower back pain for four months. A combination of haematological tests, radiographic imaging and histopathological examination was employed to diagnose echinococcosis. Imaging techniques included X-rays, ultrasound, Non Contrast Computed Tomography (NCCT) and Magnetic Resonance Imaging (MRI), which revealed multiple cystic lesions with characteristics indicative of hydatid disease. Normal haematological tests showed no acute inflammation or infection. Radiographs displayed several expansile lytic lesions in the pelvis and femur, with double-walled cystic formations and interior septations being crucial for diagnosis. MRI showed the largest cyst in the perivesical space. Histopathology revealed laminated hydatid cyst walls and reactive alterations without cellular atypia. Echinococcosis should be considered when diagnosing cystic skeletal lesions, especially in endemic areas. This challenging condition requires a multidisciplinary strategy that integrates radiographic, serological and surgical methods, emphasising the need for increased awareness and diagnostic precision in atypical presentations of echinococcosis.

Keywords

• diagnostic imaging
• pelvic hydatid disease
• skeletal cysts
• zoonotic infections