Primary hydatid cyst of the gluteal muscle: A rare case report and literature review.

INTRODUCTION

Hydatid disease, caused by Echinococcus granulosus, usually affects the liver and lungs. Musculoskeletal involvement is rare. Localization in the gluteal muscle is exceptional.

CASE PRESENTATION: We report a 47-year-old woman, presenting with a slowly enlarging, painless mass, located in the left gluteal region. Pelvic CT scan revealed a well-defined cystic lesion measuring 4.5 × 5.7 cm, without calcifications or other visceral localizations. Hydatid serology was positive. Surgical excision was performed through an elective incision with protective scolicidal measures. Puncture aspiration showed clear "rock-water" fluid, and the cyst was completely resected following irrigation with hypertonic saline. Histopathology confirmed the nature of a hydatid disease. The postoperative course was uneventful, and no recurrence was observed after a 6-month follow-up.

DISCUSSION: Intramuscular hydatid cysts represent less than 3 % of cases, with isolated soft tissue involvement being exceptionally rare. Clinical features are often nonspecific, mimicking benign soft tissue tumours. While hydatid serology may be supportive, CT-scan plays the most important role in diagnosis. Surgery remains the gold standard, with careful excision and use of scolicidal agents in order to prevent dissemination. Adjuvant antiparasitic therapy is considered in cases of incomplete resection or intraoperative rupture, to avoid recurrence.

CONCLUSION

Hydatid disease should be considered for the differential diagnosis of soft tissue masses in endemic regions. Prompt recognition and careful surgery are crucial for optimal outcomes.