Hydatid cyst in the neck, an unusual localization of the disease: A case report

INTRODUCTION AND IMPORTANCE: Hydatid cyst disease or hydatidosis is an old parasitic disease. Humans represent an accidental intermediate host. Neck is considered a rare location of hydatid cysts. It is usually overlooked as a deferential diagnosis in any cystic lesion in the neck, even in the regions where the disease is considered endemic. CASE PRESENTATION: A 26 year old female was admitted to Al-Mouwasat Hospital with the complaint of an anterior cervical mass causing compressive symptoms. Examinations determined a big cystic lesion at expense of the thyroid gland and extended to the level of aortic arch, in addition to smaller lesions in the two thyroid lobes. Multinodular goiter was diagnosed. However, Hydatid cyst disease was suspected during surgery. Cystectomy and total thyroidectomy were performed. Histopathology confirmed the diagnosis of hydatid cyst disease. CLINICAL DISCUSSION: Hydatid cyst disease in the neck is usually asymptomatic unless it compresses near structures. Histopathological study makes the definitive diagnoses. The best treatment of thyroid hydatid cysts is total surgical excision of all cysts with intensive care not to spread the disease. CONCLUSION: Hydatid cyst disease in the neck is extremely rare. Hydatid cyst should be included in differential diagnosis of cystic lesions in the neck especially in patients from endemic countries. Post-operative surveillance is important to diagnose the complete healing or recurrence of hydatid disease in operated or other locations but also for follow up of replacement therapy after total thyroidectomy as the patient require lifelong thyroid hormone replacement.