JOCS

The aim of the Comprehensive Surgery is to publish original research articles of the highest scientific and clinical value at the international level in all surgical fields.

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Case Report
Primary cervical hydatid cyst presenting as a subcutaneous neck mass: ten-year recurrence-free outcome without albendazole
Hydatid disease, caused by Echinococcus granulosus, predominantly involves the liver and lungs; primary soft-tissue involvement is exceedingly rare. Cervical localization accounts for <1% of all reported cases. Because of its atypical anatomical site and nonspecific clinical features, diagnosis is challenging, and the lesion may easily mimic benign cystic masses. We present a rare case of a primary hydatid cyst located in the left posterior cervical triangle (Level V) of a 41-year-old woman from an endemic rural region in Eastern Anatolia, Türkiye. The lesion was excised en bloc under local anesthesia, which was deemed appropriate due to its superficial position and limited size. Intraoperatively, a thick-walled cyst was identified within the subcutaneous plane. A focal pericystic breach was noted; however, the cyst was removed without spillage, and the operative field was irrigated with hypertonic saline. Histopathological evaluation confirmed a fertile hydatid cyst. Postoperative thoracoabdominal imaging and serological testing revealed no visceral involvement. Given the complete excision without contamination and the absence of systemic disease, postoperative albendazole therapy was not initiated. No recurrence was detected during a ten-year followup period. Hydatid disease should be considered in the differential diagnosis of cystic neck masses, particularly in patients from endemic areas. When feasible, meticulous excision without cyst rupture can result in a sustained disease-free outcome. Long-term clinical and radiological surveillance remains essential. In selected patients, complete excision of a primary cervical hydatid cyst without spillage may achieve long-term disease-free survival even without adjuvant albendazole therapy. Careful surgical technique and structured follow-up are critical for success.


1. Echinococcosis. [a.yer 22 Kasım 2025]. https://www.who.int/news-room/fact-sheets/detail/echinococcosis
2. Grosso G, Gruttadauria S, Biondi A, Marventano S, Mistretta A. Worldwide epidemiology of liver hydatidosis including the Mediterranean area. World J Gastroenterol. 2012;18(13):1425-1437. doi: 10.3748/wjg.v18.i13.1425
3. Morar R, Feldman C. Pulmonary echinococcosis. Eur Respir J. 2003; 21(6):1069-1077. doi:10.1183/09031936.03.00108403
4. Tappeh KH, Einshaei A, Mahmudloo R, Mohammadzadeh H, Tahermaram M, Mousavi SJ. Effect of different concentrations of hypertonic saline at different times on protoscoleces of hydatid cyst isolated from liver and lung. Turkiye Parazitol Derg. 2011;35(3):148-150. doi:10.5152/tpd.2011.37
5. Wen H, New RR, Craig PS. Diagnosis and treatment of human hydatidosis. Br J Clin Pharmacol. 1993;35(6):565-574. doi:10.1111/j.1365-2125.1993.tb04182.x
6. Nischal N, Verma AK, Bhangale D. Primary subcutaneous hydatid cyst of the face: a rare entity with emphasis on radiological evaluation. Arch Clin Infect Dis. 2017;12:e63543. doi:10.5812/archcid.63543
7. Dirican A, Unal B, Kayaalp C, Kirimlioglu V. Subcutaneous hydatid cysts occurring in the palm and the thigh: two case reports. J Med Case Rep. 2008;2:273. doi:10.1186/1752-1947-2-273
8. Rahimi MT, Hares R, Rahman H, Shinwari MA, Khaliqi S, Hares S. Primary cervical hydatid cyst: a rare case report. Int J Surg Case Rep. 2023;107:108349. doi:10.1016/j.ijscr.2023.108349
9. Centurión VRL, Vergara RMM, Kim R. Primary cervical hydatid cyst: an unusual presentation of hydatid disease: a case report. J Med Case Rep Case Series. 2024;5:14. doi:10.38207/JMCRCS/2024/NOV051402131
10. Orhan Ö, Kaptan AY, Perçin A, et al. Don't miss it: extremity-located cyst hydatid may mimic soft tissue tumors. Jt Dis Relat Surg. 2023;34(3):687-693. doi:10.52312/jdrs.2023.1371
11. Patmano M, Çetin DA, Gümüş T, Patmano G, Yenigül AE. Primary soft tissue hydatid cysts. primer yumuşak doku yerleşimli kist hidatik. Turkiye Parazitol Derg. 2022;46(2):145-149. doi:10.4274/tpd.galenos. 2021.03511
12. Karataş T, Kanlıöz M, Akın M. Breast hydatid cyst mimicking fibroadenoma and malignancy: a case report. Ulus Cerrahi Derg. 2013; 29(3):144-146. doi:10.5152/UCD.2013.2140
13. Mushtaque M, Mir MF, Lone MA, Batt SH. Solitary subcutaneous gluteal hydatid cyst: a case report. Eastern J Med. 2013;15(2):76-79.
14. Brahmachari U, Saha SS, Bhattacharya RS, et al. Primary subcutaneous hydatid cyst in supraclavicular region diagnosed by fine needle aspiration cytology: a rare case report. Sri Lankan J Infect Dis. 2015;5(1). doi:10.4038/sljid.v5i1.7613
15. Tekin R, Avci A, Tekin RC, Gem M, Cevik R. Hydatid cysts in muscles: clinical manifestations, diagnosis, and management of this atypical presentation. Rev Soc Bras Med Trop. 2015;48(5):594-598. doi:10.1590/ 0037-8682-0197-2015
16. Akal M, Kara M. Primary hydatid cyst of the posterior cervical triangle. J Laryngol Otol. 2002;116(2):153-155. doi:10.1258/0022215021909953
17. Mahmoudi A, Rachidi CA, Khattala K, Chater L, Bouabdallah Y, Afifi MA. Primary subcutaneous hydatid cyst in the left distal thigh. Eur J Orthop Surg Traumatol. 2012;22(1):177-180. doi:10.1007/s00590-012-1020-1
18. Dziri C, Haouet K, Fingerhut A. Treatment of hydatid cyst of the liver: where is the evidence?. World J Surg. 2004;28(8):731-736. doi:10.1007/s00268-004-7516-z
19. Cretu CM, Codreanu RR, Mastalier B, et al. Albendazole associated to surgery or minimally invasive procedures for hydatid disease--how much and how long. Chirurgia (Bucur). 2012;107(1):15-21.
20. Öztürk G, Uzun MA, Özkan ÖF, et al. Turkish HPB Surgery Association consensus report on hepatic cystic Echinococcosis (HCE). Turk J Surg. 2022;38(2):101-120. doi:10.47717/turkjsurg.2022.5757
21. Ok E, Sözüer EM. Solitary subcutaneous hydatid cyst: a case report. Am J Trop Med Hyg. 2000;62(5):583-584. doi:10.4269/ajtmh.2000.62.583
22. Gül A,Aguloglu B, Ozbay M, Bakir S. A rare mass in the neck region: Primary hydatid cyst. Turkish Arch Otorhinolary. 2025;50(1):12-14. doi: 10.5152/toa.2012.04
23. Celik A, Turanli M, Kutun S, et al. Unusual location of hydatid cyst: soft tissue mass in the neck. Eur Arch Otorhinolaryngol. 2006;263(12):1147-1150. doi:10.1007/s00405-006-0122-y
24. Tbini M, Lahiani R, Guelmami H, Jaafoura H, Riahi I, Bensalah M. Hydatid disease as a rare cause of neck swelling: two cases report. Int J Surg Case Rep. 2021;87:106486. doi:10.1016/j.ijscr.2021.106486
25. Muhedin SS, Tahir SH, Baba HO, et al. Hydatid cyst in the neck mimicking lymphangioma; a case report with a brief literature review. Otolaryngology Case Reports. 2022;25:100476. doi.org/10.1016/ j.xocr.2022.100476
26. Keser SH, Selek A, Ece D, et al. Review of hydatid cyst with focus on cases with unusual locations. Turk Patoloji Derg. 2017;33(1):30-36. doi: 10.5146/tjpath.2016.01369
Volume 4, Issue 1, 2026
Page : 17-20
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