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Review
. 2024 Jun 14;24(1):257.
doi: 10.1186/s12886-024-03502-w.

Orbital intramuscular hydatid cyst causing compressive optic neuropathy: a case report and literature review

Ali A Haydar  1 , Seyed Mohsen Rafizadeh  1 , Elham Rahmanikhah  1 , Zohreh Nozarian  2 , Amirhossein Aghajani  3 , Mohammad Taher Rajabi  1
Affiliations
Review

Orbital intramuscular hydatid cyst causing compressive optic neuropathy: a case report and literature review

Ali A Haydar et al. BMC Ophthalmol. .

Abstract

Background: Echinococcosis, commonly known as hydatid disease, is a zoonotic infection resulting from the tapeworm Echinococcus granulosus. The occurrence of hydatid cysts in the orbital region is uncommon, representing less than 1% of all reported hydatid cases. This report details a unique case of an intramuscular hydatid cyst in the orbital region that led to compressive optic neuropathy.

Case presentation: A 22-year-old male from Kabul, Afghanistan presented with a five-month history of progressive proptosis in his left eye, associated with a gradual decrease in vision over the past three weeks. The left eye exhibited upward globe dystopia, ocular motility limitation, mild conjunctival injection, and chemosis. Diagnosis was achieved through imaging and histopathological examination. Treatment involves surgical removal of the cyst and prolonged albendazole therapy. The postoperative course showed significant improvement in the patient's condition and restoration of his vision.

Conclusions: Despite its rarity, this case underscores the importance of awareness and knowledge of hydatid disease among physicians, especially those working in endemic areas. It emphasizes the importance of including hydatid disease in the differential diagnosis of orbital masses, particularly in endemic regions.

Keywords: Echinococcus; Endemic; Hydatid cyst; Optic neuropathy; Orbit; Zoonotic.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
A) Depicts the preoperative image exhibiting the patient’s left globe in a state of superior dystopia, accompanied by chemosis and restricted movement. (B) Displays the postoperative image showing the fully resolved conditions. (C) Illustrates a grade 5 optic nerve head swelling. (D) Demonstrates a significant improvement of optic disc swelling observed following the cyst’s removal
Fig. 2
Fig. 2
(A) This panel presents a sagittal plane computed tomographic (CT) scan of the left orbit. The scan reveals a cyst originating from the inferior rectus muscle, exerting pressure on the optic nerve, and displacing it upward. (B) A retrobulbar coronal plane CT scan illustrating the cyst in the inferior rectus muscle. (C) This panel features an axial plane MRI of the brain and orbit. The T2-weighted sequence reveals a hyperintense, well-defined, lesion (arrow) with a thick wall (arrowhead). (D) This panel illustrates the cyst after a three-step procedure: initial aspiration to decrease the cyst’s volume, followed by complete resection, and finally extensive irrigation to eliminate any remaining cystic components. (E) This pathology slide displays a germinal membrane (arrow) and protoscolices (arrowhead), which include a sucker and refractile hooklets (blue arrow), magnified 400 times
See this image and copyright information in PMC

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