Rare locations of hydatid disease evaluated by radiological imaging.

Objectives: To document unusual locations of hydatid disease by Radiological Imaging performed in a Tertiary care center. Study Design: Descriptive Case series. Setting: Department of Radiology and Imaging, HBS General Hospital, Islamabad. Period: Jan 2016 to Dec 2018. Material & Methods: 64 cases of hydatid disease were included in our study seen between 2016 and 2018. 11 cases were retrospectively analyzed because of their unusual locations. MDCT was performed in all of our cases. Ultrasound, MRI, Color Doppler, IVU, and plain films also were performed in selected cases. Histopathological diagnosis of hydatid disease was confirmed in all cases operated surgically. Results: Rare locations of hydatid disease in this series included kidney, abdominal wall, chest wall, ovary, lumbosacral spine, iliopsoas muscles, mesentery, lung hilum, diaphragm, spleen and bronchus (in form of Broncho-pleural fistula). The Table-I, is most unusual presentations were passage of cysts in urine in a case of renal hydatid cyst, passage of cysts with haemoptysis in a case of bronchopleural fistula caused by ruptured hydatid cyst, infertility in an ovarian hydatid cyst, abdominal and chest wall swellings due to hydatid cysts. Even though there was no mortality in these patients, there was disabling morbidity. Conclusion: Hydatid disease can present with unusual symptoms and signs depending on the organ of involvement. Hydatid disease can affect any organ in the body and a high suspicion of this disease is justified in any unusual cystic lesion of any organ, Moreover, detailed imaging techniques should precede and follow the surgical intervention. Multi-imaging modalities are also more helpful in rare diffuse hydatidosis.