medigraphic.com
SPANISH

Acta Ortopédica Mexicana

ISSN 2992-8036 (Electronic)
ISSN 2306-4102 (Print)
Órgano Oficial del Colegio Mexicano de Ortopedia y Traumatología
  • Contents
  • View Archive
  • Information
    • General Information        
    • Directory
  • Publish
    • Instructions for authors        
  • medigraphic.com
    • Home
    • Journals index            
    • Register / Login
  • Mi perfil

2026, Number 4

<< Back Next >>

Acta Ortop Mex 2026; 40 (4)

Extra-articular bone echinococcosis in the distal femur. Case report

Fishbein-Freiman A, Hofmeister C, Novak R, Grupper M, Fraind-Maya G, Nikomarov D
Full text How to cite this article 10.35366/124060

DOI

DOI: 10.35366/124060
URL: https://dx.doi.org/10.35366/124060

Language: Spanish
References: 26
Page: 262-267
PDF size: 1559.76 Kb.


Key words:

echinococcosis, femur, case reports.

ABSTRACT

Introduction: echinococcosis is a rare parasitic disease that mainly affects the liver and lungs; bone involvement is exceptional. The limited literature on bone involvement makes it difficult to suspect this diagnosis. The typically cystic lesions require urgent surgical resection for diagnostic confirmation and initiation of antiparasitic treatment with albendazole, thus avoiding the risk of dissemination. Clinical case: a female patient from the Middle East presents with chronic pain in her left knee that is exacerbated after trauma. Studies reveal a bone echinococcal cyst. Intralesional resection with cementoplasty impregnated with albendazole was performed, supplemented with adjuvant oral albendazole. The patient shows symptomatic improvement without recurrence. Conclusions: given the rarity of bone echinococcosis, it is essential to recognize its clinical and radiological manifestations in order to establish an early diagnosis. Surgical treatment by cyst resection is the first line of therapy, supplemented with oral antiparasitic drugs to prevent local recurrence. In patients who are not candidates for surgery, medical treatment reduces cyst size and improves quality of life. Long-term follow-up is essential to detect and treat possible recurrences early.


REFERENCES

  1. Equinococosis. Who.int. Disponible en: https://www.who.int/es/newsroom/fact-sheets/detail/echinococcosis

  2. Guidelines for treatment of cystic and alveolar echinococcosis inhumans. WHO Informal Working Group on Echinococcosis. BullWorld Health Organ. 1996; 74(3): 231-42.

  3. Brunetti E, Kern P, Vuitton DA; Writing Panel for the WHO-IWGE.Expert consensus for the diagnosis and treatment of cystic andalveolar echinococcosis in humans. Acta Trop. 2010; 114(1): 1-16.doi: 10.1016/j.actatropica.2009.11.001.

  4. Sapkas GS, Stathakopoulos DP, Babis GC, Tsarouchas JK. Hydatiddisease of bones and joints. 8 cases followed for 4-16 years. ActaOrthop Scand. 1998; 69(1): 89-94.

  5. Song XH, Ding LW, Wen H. Bone hydatid disease. Postgrad Med J.2007; 83(982): 536-42. doi: 10.1136/pgmj.2007.057166.

  6. Yagmur Y, Akbulut S. Unusual location of hydatid cysts: a casereport and literature review. Int Surg. 2012; 97(1): 23-6. doi: 10.9738/CC85.1.

  7. Gong F, Xiang J, Fu Z, Wang P, Zhou S. The diagnosis and pathologyof cystic echinococcosis of the bone: a description of two cases. QuantImaging Med Surg. 2025; 15(6): 5884-92. doi: 10.21037/qims-24-2292.

  8. Hui M, Tandon A, Prayaga AK, Patnaik S. Isolated musculoskeletalhydatid disease: diagnosis on fine needle aspiration and cell block. JParasit Dis. 2015; 39(2): 332-5. doi: 10.1007/s12639-013-0317-2.

  9. Barredo-Santamaría I, Aperribay-Ulacia M, Cancio-Fanlo J.Hidatidosis ósea del peroné. Rev Esp Patol. 2004; 37: 315-20.

  10. Lomoro P, Simonetti I, Nanni A, Cassone R, Vinci G, Fichera V, et al.Musculoskeletal hydatid disease: report of a rare case with primaryand exclusive localization in right hemi-pelvis and femur. J Biol RegulHomeost Agents. 2018; 32(6 Suppl. 1): 83-87.

  11. Zlitni M, Ezzaouia K, Lebib H, Karray M, Kooli M, Mestiri M.Hydatid cyst of bone: diagnosis and treatment. World J Surg. 2001;25(1): 75-82.

  12. Belzunegui J, Maíz O, López L, Plazaola I, González C, FigueroaM. Hydatid disease of bone with adjacent joint involvement. Aradiological follow-up of 12 years. Br J Rheumatol. 1997; 36(1): 133-5.

  13. Wirbel RJ, Mues PE, Mutschler WE, Salomon-Looijen M. Hydatiddisease of the pelvis and the femur. A case report. Acta Orthop Scand.1995; 66(5): 440-2.

  14. Ferrandez HD, Gómez-Castresana F, López-Duran L, Mata P, BrandauD, Sánchez-Barba A. Osseous hydatidosis. J Bone Joint Surg Am.1978; 60(5): 685-90.

  15. Tamarozzi F, Horton J, Muhtarov M, Ramharter M, Siles-LucasM, Gruener B, et al. A case for adoption of continuous albendazoletreatment regimen for human echinococcal infections. PLoS Negl TropDis. 2020; 14(9): e0008566. doi: 10.1371/journal.pntd.0008566.

  16. Pinto G. PP. Diagnóstico, tratamiento y seguimiento de la hidatidosis.Rev Chil Cir. 2017; 69(1): 94-8.

  17. Bhake A, Agrawal A. Hydatid disease of the spine. J Neurosci RuralPract. 2010; 1(2): 61-2. doi: 10.4103/0976-3147.71715.

  18. Teggi A, Lastilla MG, De Rosa F. Therapy of human hydatid diseasewith mebendazole and albendazole. Antimicrob Agents Chemother.

  19. 1993; 37(8): 1679-84.19. Craig PS, McManus DP, Lightowlers MW, Chabalgoity JA,Garcia HH, Gavidia CM, et al. Prevention and control of cysticechinococcosis. Lancet Infect Dis. 2007; 7(6): 385-94. doi: 10.1016/S1473-3099(07)70134-2.

  20. Horton J. Albendazole for the treatment of echinococcosis. FundamClin Pharmacol. 2003; 17(2): 205-12.

  21. Albendazole. Drugs.com. 2025. Disponible en: https://www.drugs.com/mtm/albendazole.html

  22. Pedrosa I, Saíz A, Arrazola J, Ferreirós J, Pedrosa CS. Hydatid disease:radiologic and pathologic features and complications. Radiographics.2000; 20(3): 795-817.

  23. Gupta SP, Garg G. Curettage with cement augmentation of largebone defects in giant cell tumors with pathological fractures in lowerextremitylong bones. J Orthop Traumatol. 2016; 17(3): 239-47.

  24. Wang JS, Dunne N. Bone cement fixation: acrylic cements. En: JointReplacement Technology. Elsevier; 2008. p. 212-51.

  25. Rodrigo-Pérez JL, Novoa-Parra CD, Pelayo de Tomás JM, Blas DobónJA, Morales Suárez-Varea M. Uso del cemento con antibióticos comoprofilaxis en artroplastías de cadera: revisión de la bibliografía.Rev Latinoam Cir Ortop. 2016; 1(3): 108-15. doi: 10.1016/j.rslaot.2017.01.001.

  26. Pazarci O, Oztemur Z, Bulut O. Treatment of bifocal cyst hydatidinvolvement in right femur with teicoplanin added bone cement andalbendazole. Case Rep Orthop. 2015; 2015: 824824.




CC BY-NC-ND

2020     |     www.medigraphic.com

Mi perfil

C?MO CITAR (Vancouver)

Acta Ortop Mex. 2026 Jul-Ago;40