Tibial hydatidosis: a case report.

BACKGROUND: Hydatidosis is a tapeworm infection caused by the larval stage of Echinococcus species. The organs most frequently affected are the liver and the lungs. Primary involvement of the skeleton is rare. The location of hydatid cysts in the tibia is seldom described in the medical literature, and its diagnosis is challenging and often presenting with a pathologic fracture simulating benign bone cystic lesion. CASE PRESENTATION: We report a 53-year-old Tigrian woman who developed hydatid disease of the tibia. CONCLUSION: The diagnosis of primary bone hydatid disease, especially tibial hydatidosis, is difficult and requires high index of suspicion. Hence, orthopedic surgeons should be aware of this disease. Moreover, it should be considered in preoperative differential diagnosis of destructive bone lesions especially in endemic areas.

Composite treatment for primary long-bone hydatidosis.

Hydatid disease is a parasitic tapeworm infection caused by the Echinococcus species. Involvement of the long tubular bones is rare in hydatid bone disease. Patients are initially asymptomatic and usually present at a later stage of the disease when the bony lesions are extensive. Diagnosing bone hydatid disease is challenging, even in endemic regions, and a high index of suspicion is required because the radiologic findings often mimic other bone pathologies. Recurrence following treatment can occur after a long period of quiescence.This article describes a case of hydatid disease in a 62-year-old woman with extensive diaphyseal tibial involvement. She was treated with initial chemotherapy followed by extended curettage, polymethylmethacrylate cementation, and intramedullary fixation. Functional outcome was excellent, with no recurrence at 60-month follow-up. She was fully weight bearing with no pain or discomfort and had full hip, knee, and ankle range of motion.This case was important due to its rarity, the diagnostic challenge it presented, and the composite nature of the treatment used to avoid recurrence. Diaphyseal bone hydatidosis can be initially treated like a low-grade malignant tumor with curettage and high-speed burring, followed by filling the defect with polymethylmethacrylate cement. The composite treatment of chemotherapy with the surgical protocol described offers a reasonable chance of long-term disease suppression. Recurrent disease can be treated with repeat curettage and cementation. Wide excision with reconstruction of the resulting defect should only be considered for recalcitrant diaphyseal hydatid disease.

Case report: Lower extremity sparganosis in a bursa.

BACKGROUND: Sparganosis is a rare parasitic infection caused by the plerocercoid tapeworm larva of the genus Spirometra. CASE DESCRIPTION: We report the case of a 67-year-old man with a mass over the anteromedial surface of the proximal extremity of the tibia. We surgically excised a bursa containing Spirometra larvae. LITERATURE REVIEW: Sparganosis is a rare parasitic infection. We found no cases of lower extremity sparganosis combined with bursitis reported in the literature. PURPOSES AND CLINICAL RELEVANCE: Sparganosis should be considered in the differential diagnosis of soft tissue tumors, especially among patients who frequently have consumed mountain water or raw snakes or frogs.

Incidental detection of microfilariae in aspirates from Ewing's sarcoma of bone.

Microfilariae have been reported as coincidental findings with various neoplasms. We present a case in which microfilariae were encountered in fine-needle aspiration (FNA) smears from a 10-yr-old boy who presented with a lytic lesion in the diaphysis of the right tibial bone. Stained aspirates from the swelling were composed of a dispersed population of small round cells with scanty to vacuolated cytoplasm. Two sheathed microfilariae with several nuclei and cephalic and caudal clearing were identified. A diagnosis of Ewing's sarcoma with presence of microfilariae of Wuchereria bancrofti was made. The diagnosis of Ewing's sarcoma was confirmed on histopathology.

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.

Onchocerciasis in Minnesota cattle.

Umbilical hides from 536 dairy cattle in Minnesota were tested for the microfilarial stage of Onchocerca species to determine the distribution of onchocerciasis in the state. The infection was widespread as microfilariae were obtained from 214 (40%) of the animals, representing nearly all areas of the state. Adult Onchocerca parasites were collected primarily from nodules associated with tibial bones but also were found to a lesser extent within the gastrosplenic ligament. Specific identity of these organisms is unclear as they exhibit certain morphological features previously described as being characteristic of either Onchocerca gutturosa, Onchocerca lienalis, or Onchocerca stilesi.

[2 cases of hydatidosis in the Republic of Niger]. / Deux cas d'hydatidose en République du Niger.

Two cases of hydatidosis have been observed at the hospital of Niamey, one involving the tibia and the other one the liver and the spleen. For unknown epidemiological factors, this helminthiasis is rare in man in western Africa.