Primary subcutaneous hydatid cyst of the thigh: An unusual site with a diagnostic dilemma

Background: Hydatid disease, or echinococcosis, affects several organs in the body and can pose a major diagnostic dilemma. Musculoskeletal involvement occurs only in 1% to 6% of patients. Clinically, the condition mimics a soft tissue tumor, and a preoperative diagnosis (blood and radiology) is necessary to avoid biopsy, management, and recurrence. In endemic areas, a differential diagnosis of hydatid disease should be considered for every soft cystic mass in any anatomic location. Methods: The investigators report a rare case of primary subcutaneous hydatid cyst of the thigh, which was an incidental clinical and radiologic finding that led to a diagnostic dilemma in a 62-year-old woman with diabetes admitted for management of a nonhealing foot ulcer. Results: The patient underwent successful complete surgical excision with pre- and postoperative antihelminthic pharmacotherapy, and at the end of 2-year follow-up, there has been no local recurrence or systemic disease.