Orbital and medial rectus muscle involvement as initial presentations of hydatid disease

Abstract Purpose To report a rare case of orbital hydatid cyst involving the medial rectus muscle, which presented as progressive proptosis, with subsequent detection of liver involvement after further investigations. Case presentation We present the case of a 12-year-old boy from a rural area with...

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Main Authors: Seyed Mohsen Rafizadeh, Amir Mousavi, Mohammad Taher Rajabi, Amirhossein Aghajani, Zohreh Nozarian, Amin Zand
Format: Article
Language:English
Published: SpringerOpen 2025-03-01
Series:Journal of Ophthalmic Inflammation and Infection
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Online Access:https://doi.org/10.1186/s12348-025-00476-8
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author Seyed Mohsen Rafizadeh
Amir Mousavi
Mohammad Taher Rajabi
Amirhossein Aghajani
Zohreh Nozarian
Amin Zand
author_facet Seyed Mohsen Rafizadeh
Amir Mousavi
Mohammad Taher Rajabi
Amirhossein Aghajani
Zohreh Nozarian
Amin Zand
author_sort Seyed Mohsen Rafizadeh
collection DOAJ
description Abstract Purpose To report a rare case of orbital hydatid cyst involving the medial rectus muscle, which presented as progressive proptosis, with subsequent detection of liver involvement after further investigations. Case presentation We present the case of a 12-year-old boy from a rural area with exposure to wildlife dogs. The patient had a two-month history of gradually progressive proptosis in the right eye, accompanied by periorbital swelling and limited medial ocular motility. Orbital magnetic resonance imaging (MRI) revealed a large mass within the medial rectus muscle, which showed peripheral enhancement with no central enhancement, consistent with a cystic lesion based on its imaging characteristics. The patient underwent orbitotomy, during which the lesion was aspirated, and its walls were resected. Pathological examination confirmed a structure of a hydatid cyst. Given the suggestive signs of a hydatid cyst as part of a systemic echinococcal infection, further investigations, including liver sonography, revealed a similar cystic lesion in the hepatic lobe. With the diagnosis of an orbital hydatid cyst and suspected echinococcal infection, the patient was treated with oral Albendazole for one month. His symptoms, including periorbital swelling, improved, and no recurrence was observed at a six-month follow-up. Conclusions Orbital hydatid cysts may present as inflammatory proptosis and should be considered in populations from endemic areas of human echinococcosis. Early diagnosis using orbital MRI, systemic investigations such as liver sonography, timely surgery for definitive diagnosis and treatment, and appropriate adjuvant antiparasitic medication are crucial for effective management.
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spelling doaj-art-c09bfef7ef7a49118c2fe47f05f02be82025-08-20T03:05:45ZengSpringerOpenJournal of Ophthalmic Inflammation and Infection1869-57602025-03-011511610.1186/s12348-025-00476-8Orbital and medial rectus muscle involvement as initial presentations of hydatid diseaseSeyed Mohsen Rafizadeh0Amir Mousavi1Mohammad Taher Rajabi2Amirhossein Aghajani3Zohreh Nozarian4Amin Zand5Department of Oculo-Facial Plastic and Reconstructive Surgery, Farabi Eye Hospital, Tehran University of Medical SciencesDepartment of Oculo-Facial Plastic and Reconstructive Surgery, Farabi Eye Hospital, Tehran University of Medical SciencesDepartment of Oculo-Facial Plastic and Reconstructive Surgery, Farabi Eye Hospital, Tehran University of Medical SciencesDepartment of Oculo-Facial Plastic and Reconstructive Surgery, Farabi Eye Hospital, Tehran University of Medical SciencesDepartment of Pathology, Farabi Eye Hospital, Tehran University of Medical SciencesDepartment of Oculo-Facial Plastic and Reconstructive Surgery, Farabi Eye Hospital, Tehran University of Medical SciencesAbstract Purpose To report a rare case of orbital hydatid cyst involving the medial rectus muscle, which presented as progressive proptosis, with subsequent detection of liver involvement after further investigations. Case presentation We present the case of a 12-year-old boy from a rural area with exposure to wildlife dogs. The patient had a two-month history of gradually progressive proptosis in the right eye, accompanied by periorbital swelling and limited medial ocular motility. Orbital magnetic resonance imaging (MRI) revealed a large mass within the medial rectus muscle, which showed peripheral enhancement with no central enhancement, consistent with a cystic lesion based on its imaging characteristics. The patient underwent orbitotomy, during which the lesion was aspirated, and its walls were resected. Pathological examination confirmed a structure of a hydatid cyst. Given the suggestive signs of a hydatid cyst as part of a systemic echinococcal infection, further investigations, including liver sonography, revealed a similar cystic lesion in the hepatic lobe. With the diagnosis of an orbital hydatid cyst and suspected echinococcal infection, the patient was treated with oral Albendazole for one month. His symptoms, including periorbital swelling, improved, and no recurrence was observed at a six-month follow-up. Conclusions Orbital hydatid cysts may present as inflammatory proptosis and should be considered in populations from endemic areas of human echinococcosis. Early diagnosis using orbital MRI, systemic investigations such as liver sonography, timely surgery for definitive diagnosis and treatment, and appropriate adjuvant antiparasitic medication are crucial for effective management.https://doi.org/10.1186/s12348-025-00476-8Hydatid cystHydatid diseaseOrbital cystEchinococcosis
spellingShingle Seyed Mohsen Rafizadeh
Amir Mousavi
Mohammad Taher Rajabi
Amirhossein Aghajani
Zohreh Nozarian
Amin Zand
Orbital and medial rectus muscle involvement as initial presentations of hydatid disease
Journal of Ophthalmic Inflammation and Infection
Hydatid cyst
Hydatid disease
Orbital cyst
Echinococcosis
title Orbital and medial rectus muscle involvement as initial presentations of hydatid disease
title_full Orbital and medial rectus muscle involvement as initial presentations of hydatid disease
title_fullStr Orbital and medial rectus muscle involvement as initial presentations of hydatid disease
title_full_unstemmed Orbital and medial rectus muscle involvement as initial presentations of hydatid disease
title_short Orbital and medial rectus muscle involvement as initial presentations of hydatid disease
title_sort orbital and medial rectus muscle involvement as initial presentations of hydatid disease
topic Hydatid cyst
Hydatid disease
Orbital cyst
Echinococcosis
url https://doi.org/10.1186/s12348-025-00476-8
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