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Case Reports
. 2024 Nov 29;24(1):1369.
doi: 10.1186/s12879-024-10270-x.

From mammary mystery to parasitic surprise: a rare case of primary breast hydatid cyst

Nazanin Zeinali Nezhad  1 , Hamid Zeinali Nezhad  2 , Amirhossein Shahpar  3 , Aazam Gholami Shahrebabak  4 , Maryam Gholami Shahrebabak  5 , Faride Rashid Farokhi  2
Affiliations
Case Reports

From mammary mystery to parasitic surprise: a rare case of primary breast hydatid cyst

Nazanin Zeinali Nezhad et al. BMC Infect Dis. .

Abstract

Background: Primary breast hydatid cyst is an exceedingly rare manifestation of echinococcosis, with an incidence of less than 0.27% among all hydatid cyst cases.

Case report: This report presents a unique case of a 51-year-old multiparous female who initially presented with a painless left breast mass. Initial imaging studies, including ultrasonography and mammography, revealed a 4.5 × 4 cm cyst classified as BI-RADS 3. The cyst was initially managed with fine-needle aspiration and conservative treatment. However, it recurred twice over a six-month period, necessitating surgical excision. Preoperative laboratory work ups revealed eosinophilia, a finding initially overlooked but later recognized as significant. Histopathological examination of the excised specimen confirmed the diagnosis of a hydatid cyst. Post-surgical management included albendazole therapy, regular imaging follow-ups, and patient education on hygiene practices to prevent reinfection.

Conclusion: This case highlights the importance of considering parasitic etiologies in the differential diagnosis of breast masses, particularly in endemic regions. It also underscores the value of a multidisciplinary approach in managing such rare cases. The unexpected diagnosis of a primary breast hydatid cyst in this case serves as a reminder of the diverse presentations of echinococcosis and the need for heightened clinical suspicion in atypical breast lesions.

Clinical trial number: Not applicable.

Keywords: Breast; Cyst; Hydatid; Infection; Surgery.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This case report was conducted in full adherence to the highest ethical standards in medical research and publishing. The study meticulously followed the ethical guidelines set forth by the institutional and national research committees, as well as the principles outlined in the 1964 Helsinki Declaration and its subsequent amendments. It is important to note that this article does not include any studies involving animals. The authors have taken extensive measures to protect the patient’s privacy and maintain confidentiality. All identifying information, including the patient’s name, initials, and other potentially identifiable details, have been omitted from this report. Furthermore, no images that could potentially identify the patient have been included in this publication.The preparation of this case report encountered no ethical challenges. Throughout the process, the patient’s autonomy and privacy were consistently respected. The medical history and treatment details have been presented with the utmost discretion and sensitivity, ensuring that the patient’s dignity is preserved while maintaining the scientific value of the report. Consent for publication: Each author listed assumes responsibility for the overall integrity of the work and has provided consent for the publication of this version. Consent statement: A written informed consent was obtained from the patient to publish this report in any medical journals. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Histopathological examination of breast hydatid cyst. (A) Low-power magnification showing breast tissue with fibrotic changes surrounding the hydatid cyst (red pointer: normal breast tissue; light blue pointer: fibrotic changes). (B) The black pointer indicates the laminated layer, which is the outer acellular layer of the hydatid cyst. (C) High-power magnification demonstrating the characteristic layers of the hydatid cyst (light blue pointer: protoscoleces; red pointer: germinal layer; orange pointer: laminated layer). (D) Another high-power view showing multiple protoscoleces (light blue arrow), germinal layer (red arrow), and laminated layer (orange arrow). These histopathological findings confirm the diagnosis of breast hydatid cyst, showing the typical parasitic structures of Echinococcus granulosus
See this image and copyright information in PMC

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