Primary hydatid cyst of thyroid gland is an exceptional localization even in Morocco where echinococcal disease is endemic. A 23-year-old woman presented with multiples cystic lesions of the thyroid revealed by neck mass and dyspnea. She underwent a subtotal thyroidectomy. The diagnosis of hydatid cyst was made preoperatively and was confirmed by histological studies. Further investigation failed to identify any other evidence of systemic hydatidosis. The patient has remained asymptomatic for 24 months after surgery. The possibility of hydatid disease, though rare, should be always kept in mind, for patients with cystic lesions of the thyroid, because a needle aspiration biopsy is a potentially harmful procedure.
Hydatid disease (HD) is a zoonotic infestation caused by Echinococcus granulosus and Echinococcus multilocularis. Thyroid gland is very rarely involved by this parasitic infection even in countries where the disease is endemic [
A 23-year-old woman, without any history of farming or raising livestock, presented with an enlarging neck mass, which was noticed 18 months before her presentation. On examination, a well-circumscribed
Thyroid ultrasonography showed a large lobulated cystic lesion in the right thyroid lobe and multiples adjacent little cysts in isthmus.
Removed thyroid right lobe and isthmus which includes a 30 mm cystic nodule in the right thyroid lobe contained germinate membrane and daughter vesicles.
Histopathologic examination of the removed thyroid and cyst. A dense hyalinized fibrous tissue and a mixed inflammatory infiltrate (including eosinophils) were present between the cyst and thyroid tissue. HE×40.
Hydatid disease is a parasitic infection with worldwide distribution, especially in sheep and cattle-rearing regions of Australia, South America, the Middle East, South Africa, Eastern Europe, and the Mediterranean region [
The parasitic embryo can enter the systemic circulation and lodge in the thyroid gland after either bypassing (primary type) or passing through (secondary type) the hepatic microcirculation [
Radiologic signs are usually nonspecific. Hydatid origin was suspected in only 50% of patients preoperatively and immunologic testing had a 33% false-positive rate [
Management of thyroid hydatid cyst is surgical. Complete excision should be the procedure of choice. The commonly held opinion is that echinococcal cysts should be radically removed whenever possible [
In conclusion, hydatid cyst in the thyroid gland is rare. Although inhomogeneous appearance of cystic echinococcosis makes its radiologic diagnosis difficult [