Introduction: Hydatid disease is a parasitic infection caused by Echinococcus species, commonly involving the liver and lungs. Primary localization in the abdominal wall is exceptional and may lead to diagnostic confusion, especially in endemic regions. Case presentation: An adult patient presented with a progressively enlarging, painful mass in the right abdominal wall. Clinical examination revealed a well-defined intramuscular lesion. Imaging showed a cystic mass within the abdominal wall musculature without intra-abdominal extension. The appearance did not suggest a parasitic origin. Complete surgical excision was performed. Histopathological analysis unexpectedly confirmed a hydatid cyst. Postoperative albendazole therapy was administered. The patient had an uneventful recovery with no recurrence on follow-up. Discussion: Abdominal wall hydatid cysts are rare and often mimic benign cysts or soft tissue tumors. Imaging may identify a cystic lesion but is not always diagnostic in atypical sites. Surgical excision without rupture is the treatment of choice to prevent dissemination. Adjunctive albendazole therapy helps reduce the recurrence risk. This unusual presentation highlights the need to consider hydatid disease in the differential diagnosis of cystic or soft tissue masses in endemic areas. Conclusion: Primary abdominal wall hydatid cyst is a rare entity with a nonspecific presentation. Awareness of this possibility allows for appropriate surgical management and favorable outcomes.
Bourabaa et al. (Wed,) studied this question.