Daughter cyst sign in isolated peritoneal hydatid disease.

A 35-year-old patient with no pertinent past medical history presented with recurrent abdominal pain of three months duration. There were no associated symptoms. The abdominal ultrasound showed a homogenous, well-circumscribed cystic mass in the pelvic cavity. The immunology of cystic echinococcosis was negative. Abdomen and pelvis CT scan revealed a pelvic cyst measuring six centimeters in diameter. The cyst wall appeared bumpy and communicated with a second adjacent small rounded lesion corresponding to a daughter cyst (figure). The rest of the imaging findings were unremarkable. The diagnosis of isolated peritoneal hydatid cyst was made. The patient underwent a cystectomy with uneventful postoperative course. Daughter cysts formation is common in the parasite evolution. They are usually endogenous [1]. In some cases, the daughter cysts are progressively pushed outwards and develop as exogenous extensions [2]. The daughter cyst sign is pathognomonic for hydatid disease and is usually seen in liver hydatid cysts. Daughter cysts are associated with a high risk of recurrence after surgery. Radical excision is to be preferred in these cases [3].

A rare case presentation of hydatid cyst in ilio-psoas muscle

We report a rare case of hydatid cyst in iliopsoas muscle in 35-year-old male patient. Where, patient presented with pain and swelling in right groin and fixed flexion deformity of right lower limb with constitutional symptoms. CECT abdomen revealed hydatis cyst with daughter cyst. We performed excision by retroperitoneal approach through lumber incision. Cyst was completely removed with daughter cysts.