ABSTRACT
Osseous hydatidosis is reported in only 0.5-2.5% of the cases. The scapulohumeral localization is extremely rare. A 39-year-old woman, born in a rural area of Tunisia, presented swelling and tenderness of the left shoulder with limited motion 7 days after a minor trauma. Plain radiographs, CT and MRI showed osteolytic scapulohumeral lesions, cortical rupture and multiple cysts in the muscles, which were suggestive of hydatidosis. Indirect haemagglutination test using hydatid antigen was positive (1/280). The patient refused radical surgery and underwent resection of axillary cysts. Albendazole was given in the recommended dose but was stopped immediately due to hepatic toxicity. Scapulohumeral hydatidosis is extremely rare, often invasive and behaves like a locally malignant bone tumour. Its treatment is also difficult.
Subject(s)
Bone Diseases, Infectious/diagnostic imaging , Echinococcosis/diagnostic imaging , Humerus/diagnostic imaging , Scapula/diagnostic imaging , Adult , Female , Humans , Humerus/parasitology , Humerus/pathology , Magnetic Resonance Imaging , Scapula/parasitology , Scapula/pathology , Tomography, X-Ray Computed , TunisiaSubject(s)
Bone Diseases, Infectious/pathology , Echinococcosis/pathology , Humerus/parasitology , Albendazole/therapeutic use , Anthelmintics/therapeutic use , Bone Diseases, Infectious/diagnostic imaging , Bone Diseases, Infectious/therapy , Bone Plates , Curettage , Echinococcosis/diagnostic imaging , Echinococcosis/drug therapy , Humans , Humerus/surgery , Male , Middle Aged , RadiographyABSTRACT
No disponible
Subject(s)
Female , Middle Aged , Humans , Echinococcosis , Bone Cysts/parasitology , Humerus/parasitologyABSTRACT
Hydatidosis of bone is rare. Vertebral localizations predominate. Standard imaging may be misleading, suggestive of a malignant tumor or infection. We present the case of a patient with a humeral hydatid. This localization is very rare and presents an unusual radiographic aspect. Computed tomography produces an image suggestive of a tumor. The correct diagnosis can be established with MRI, particularly with the STIR sequence. In our patient, MRI enabled us to establish the diagnosis preoperatively and evaluate extension. MRI has been found to be highly contributive to the diagnosis of hydatidosis of bone and for assessment of intra- and peri-osseous extension.
Subject(s)
Echinococcosis/diagnosis , Echinococcosis/pathology , Humerus/pathology , Humerus/parasitology , Adult , Bone Neoplasms/diagnosis , Bone Neoplasms/pathology , Diagnosis, Differential , Humans , Magnetic Resonance Imaging , MaleABSTRACT
Presentamos el caso de un hombre de 32 años con enfermedad hidatídica humeral complicada con fractura patológica y extensión extraósea. Se estableció el diagnóstico mediante radiografías, TC y laboratorio. La evolución postquirúrgica resultó favorable. Señalamos la importancia de considerar la hidatidosis ósea en el diagnóstico diferencial de lesiones destructivas óseas y como posible causa de masa palpable en la pared torácica, especialmente en regiones endémicas
Subject(s)
Humans , Male , Adult , Echinococcosis , Scapula/parasitology , Fractures, Spontaneous/etiology , Humerus/parasitology , Tomography, X-Ray ComputedABSTRACT
Presentamos el caso de un hombre de 32 años con enfermedad hidatídica humeral complicada con fractura patológica y extensión extraósea. Se estableció el diagnóstico mediante radiografías, TC y laboratorio. La evolución postquirúrgica resultó favorable. Señalamos la importancia de considerar la hidatidosis ósea en el diagnóstico diferencial de lesiones destructivas óseas y como posible causa de masa palpable en la pared torácica, especialmente en regiones endémicas (AU)
Subject(s)
Humans , Male , Adult , Echinococcosis/diagnosis , Echinococcosis/diagnostic imaging , Humerus/parasitology , Scapula/parasitology , Tomography, X-Ray Computed , Fractures, Spontaneous/etiologyABSTRACT
Hydatid cysts caused by E. multilocularis are less common than those caused by E. granulosus (Pintilie et al., 1996). Infection in the bones is rare, accounts to 0.9-2% of all hydatid cysts (Wirbel et al., 1997). A thirty-five-year old female was presented with a four month history of pain and swelling in her humerus. Plain radiography (Fig. 1) and ultrasonography revealed partial destruction of bone. Laboratory investigations revealed Hb, 15.2 gm, ESR, 11 1st hr and WBC, 10,000. Indirect haemagglutination test using hydatid antigen was positive (1/16,000) and ELISA (IgG) was positive (1/4096). Lung, liver and brain scans were normal. Endosteal-sarcoma was considered and a biopsy was performed. Histopathological examination of bone tissue, showed many cysts (Fig. 11). On surgical operation, a huge number of cysts were found, and removed. The patient was given Albendazole in the recommended dose (Mazyad et al., 1998), and followed up. Six months later, all symptoms and signs regressed. Again three months more, the serological levels markedly decreased and X ray was normal.
Subject(s)
Bone Diseases/surgery , Echinococcosis/surgery , Humerus/parasitology , Adult , Albendazole/therapeutic use , Anthelmintics/therapeutic use , Bone Diseases/drug therapy , Bone Diseases/parasitology , Echinococcosis/drug therapy , Female , Humans , Humerus/diagnostic imaging , Radiography , UltrasonographyABSTRACT
The clinical case of an apparently healthy 63-year-old man from a rural area, with previous contact with dogs, who had a pathological fracture of the right humerus in presented. Initially he presented slight local pain, and functional discapacity. Eigh months later, after a radiological study and surgery (curettage), diagnosis of hydatid disease was made. Later on, after receiving two courses with albendazole, the parient continued in similar conditions for seven years, when his situation became complicated with bacterial, fistula and extraoseous hydatidosis. The humeral was resected and a segmentary prothesis was successfully set
