Multiple pelvic and thigh hydatid cyst: a case report

Bone cystic echinococcosis is rare disease and its management remain difficult to treat due to frequent recurrences, related to certain locations such as proximal femur and ilium, where radical surgery is difficult to achieve. Medical therapy using Mebendazol can be an ultimate way to insure stabilization and remission of the parasitosis. We present a case of a 37-year-old male who had complaints of pain in left hip and limp four years after surgical management of pertrochanteric fracture of his right lower limb. The first clinical and radiological diagnosis was osteoarthritis of proximal femur and hip. However, higher imaging modalities revealed the diagnosis of hydatid disease of hip with extensive pelvic hydatid cyst localizations. The patient underwent anthelminthic chemotherapy. At 7 years follow-up, the lesions remains stable and the patient has tolerate hip pain, support and walking are impossible without crutches. Hydatid disease of the proximal femur and pelvis must be kept in mind in the differential diagnosis of pathologies of hip-like septic arthritis or tuberculosis. Prolonged medical therapy with anthelmintic medications can constitute an alternative to surgery at very high risk and for extensive lesions where surgery can not achieve carcinologic goals.