Paraspinal lumbar hydatid disease: common Dx in an unusual l
Although the liver and lung are the most common sites of hydatid disease, it can also be seen in other organs due to migration via systemic circulation. The present case has been published in the Turkish Journal of Surgery.

A 51-year-old woman presented with swelling in the left lumbar region. The patient complained of slowly growing swelling in the lumbar region and noticed pain and tenderness since the last 1 week. Patient's medical history and physical examination and laboratory test findings were unremarkable. Ultrasonography of the patient demonstrated a mass with cystic and solid portions.

MRI revealed a well-defined mass that was located in the lumbar paraspinal muscles. The mass was hypointense on T1-weighted images (Figure 1a), was hyperintense on T2-weighted images (Figure 1b), and showed only peripheral enhancement after the injection of gadolinium contrast media (Figure 1c). There was no spinal or intraspinal extension.

Although the lumbar paraspinal muscle is not a common location of HD, because of imaging findings, particularly multiple well-circumscribed small cysts resembling daughter cysts, the differential diagnosis was suggested to be HD.

A serological test was performed and was found to be negative for HD. The negative serology did not exclude the diagnosis, and therefore, surgical excision was considered. After complete resection of the soft tissue mass, macroscopic evaluation of the intramuscular mass with round vesicles was indicative of HD. Microscopic examination revealed the cuticular membranes of the hydatid cysts and the outer fibrous capsule.

Key takeaway:-
- Hydatid disease should be considered as the differential diagnosis in patients with a lumbar paraspinal mass, particularly that containing multiple well-defined, round, small cysts, and in patients living in or traveling to endemic regions.

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