Primary hydatid cyst of the root of the thigh: a case report and review of the literature.

Hydatid disease of bone is a rare event, and it is characterized by a high diagnostic and therapeutic complexity. We report a case of primary hydatidosis of the proximal thigh involving both the soft tissues and the proximal femur in a 59-year-old man. It has been possible to establish the diagnosis only 8 years after the appearance of the first symptoms (painful swelling over the root of the left thigh), when the patient came to our institution after several investigations.

Bone lymphangiomatosis: treatment with percutaneous cementoplasty.

STUDY DESIGN: Case report, minimally invasive technique. OBJECTIVES: Disseminated lymphangiomatosis is a rare disorder that can produce clinical manifestation secondary to soft tissue, visceral and bone involvement. The overall prognosis of this disorder is usually poor, and the current treatment options for its sequelae are limited and only palliative. In this report, we present the use of cementoplasty in the percutaneous treatment of a sacral lymphangiomatous bone lesion producing severe pain. SUMMARY OF BACKGROUND DATA: Disseminated lymphangiomatosis is a rare disorder that can produce clinical manifestation secondary to soft tissue, visceral, and bone involvement. Major morbidity related to skeletal involvement requiring surgical intervention is less common than that related to visceral involvement, but it has been reported in a few case reports to palliate neurologic sequelae secondary to vertebral involvement. We present case of osteoplasty used to treat a painful osteolytic sacral lesion in a patient with diffuse lymphangiomatosis. Computed tomography guided osteoplasty injecting acrylic bone cement into the lesion resulted in almost immediate reduction in pain. METHODS: The technique and results of minimally invasive percutaneous computed tomography-guided cementoplasty of a painful osteolytic sacral lesion resulting from chylous reflux in a patient with lymphangiomatosis is presented. RESULTS: Computed tomography was used to accurately position a 13-gauge needle into a dominant sacral osteolytic lesion. The injection of bone cement into the sacral lesion was then monitored by intermittent CT imaging. The patient reported substantial pain relief within several hours of the procedure. CONCLUSION: The case presented demonstrates the feasibility and efficacy of computed tomography-guided cementoplasty used to palliate unusual causes of benign osteolytic bone lesions. These procedures can be performed as outpatients with minimal recovery.

Echinococcosis granulosus/cysticus of the tibia.

Hydatid disease is caused by the parasitic tapeworm Echinococcus. There are three species: E. granulosus, E. alveolaris and E. voegeli. Only E. alveolaris and E. granulosus are important for human infections. These two species are totally divergent in their manner of infestation. Hydatid disease is a rare parasitic disease that primary involves the liver and the lung. Skeletal disease is rare, accounting for less than 2% of all hydatid lesions, and often presents as a clinical and radiologic diagnostic problem. The skeletal involvement is usually due to secondary extension after haematogenous spread of the infection. The vertebral column, the pelvis and the skull are most commonly involved. Treatment is also difficult because of the invasive nature of bony involvement and the spillage of fluid with subsequent contamination seeding. We present a case of primary hyatid cyst of the tibia. We point out the importance of considering osseous hydatidosis in the differential diagnosis of destructive bone lesions and the necessity of radical resection.