Hydatidosis of the neck in a young adult female from Karamoja in Uganda: a case report

Primary cervical hydatid disease is extremely rare with prevalence reported being less than 1%, and this disease may mimic several neck pathologies. This case emphasizes the importance of including hydatid cysts in differentials for cystic neck masses in endemic areas. Herein, we present the case of a 25-year-old Ugandan female from an endemic pastoral region presented with a painless, gradually growing mass in the right supraclavicular region for a duration of 10 months. However, the patient had no episodes of fever, cough, weight loss, night sweats, or any other swelling in the body. Preoperative ultrasound scan revealed multiple daughter cysts in a cystic mass (mother cyst) which gave an impression of hydatid cyst. Enhanced helical axial neck CT scans were done with reformats which revealed a large well-defined hypo-attenuating non-enhancing multiloculated thin-walled cystic mass in the right supraclavicular region. Histologically, the specimen showed an acellular characteristic laminated membrane and lined by a germinal epithelium which confirmed the diagnosis of hydatidosis. The cystic mass was surgically excised followed by prescription with albendazole for prevention of secondary hydatidosis. The patient remained asymptomatic with no radiological recurrence at 20 months. The importance of reporting this case is that it is extremely rare, and it is associated with diagnostic challenges and surgical treatment complications due to its anatomical location and friable nature of the cysts. The 20-month recurrence-free follow-up observed in this report provides evidence that adequate surgical removal of the hydatid cysts offers optimal outcome including prevention of recurrence.