title: Solitary subcutaneous hydatid cyst: review of the literature and report of a new case in the deltoid region.
abstract: BACKGROUND
  Solitary subcutaneous hydatid cyst is not frequent and the only symptom is generally a silent growing mass. Total excision remains the mainstay of treatment. Aim of the study was to present a case surgically treated and perform a statistical analysis reviewing previous published works in order to define a correct approach to diagnosis and treatment.
  
  
  METHODS
  264 documents from Medline database were considered for primary subcutaneous hydatid cyst cases. Data concerning geographic region, gender, age, job, location, evolving time, history and physical, mobility, diameter, laboratory, imaging, locularity (uni- or multilocular cyst), fine-needle aspiration, preoperative diagnosis, neoadjuvant chemotherapy, treatment, spillage, adjuvant therapy, follow-up and recurrences were ordered in a database and analysed performing t-test, Fisher's test and Pearson's test.
  
  
  RESULTS
  23 cases, included ours, resulted suitable for our study. Lower extremities were involved in most cases (60.9%) and the thigh represented the most common site (34.8%), whereas upper extremities were the rarest location (8.7%). Patients with head and neck located cysts were younger than those with upper extremities cysts (P=0.037). Patients who underwent multiple imaging approach received a significantly correct first diagnosis (P=0.001) and ultrasonography, unlike other techniques, appeared to be essential (P=0.013).
  
  
  METHODS
  A 68-year-old man who lived and worked in his farm in Sicily (Italy) presented with a 30-year-growing mass in the deltoid region measuring 10 cm. Ultrasonography and magnetic resonance imaging strongly suggested hydatid cyst. Therefore the cyst was excised and pathology confirmed the diagnosis.
  
  
  CONCLUSIONS
  Solitary subcutaneous hydatid cyst must always be considered in the differential diagnosis of silent growing mass in soft tissues. History and physical associated with ultrasound and magnetic resonance imaging are sufficient to achieve a correct preoperative diagnosis.
authors.affiliation: Department of Surgery, University of Catania, Policlinico-Vittorio Emanuele University Hospital, Catania, Italy.
authors.forename: Rosario
authors.initials: R
authors.lastname: Vecchio
authors.forename: Salvatore
authors.initials: S
authors.lastname: Marchese
authors.forename: Francesco
authors.initials: F
authors.lastname: Ferla
authors.forename: Linda
authors.initials: L
authors.lastname: Spataro
authors.forename: Eva
authors.initials: E
authors.lastname: Intagliata
mesh_terms: D000368:Aged; D015766:Albendazole / Q000008:administration & dosage; D000818:Animals; D000871:Anthelmintics / Q000008:administration & dosage; D057645:Deltoid Muscle / Q000469:parasitology; D003937:Diagnosis, Differential; D004443:Echinococcosis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D048209:Echinococcus granulosus / Q000302:isolation & purification*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009135:Muscular Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000469:parasitology; D011859:Radiography; D040521:Subcutaneous Tissue / Q000469:parasitology
chemical_list: D000871:Anthelmintics; D015766:Albendazole
keywords: Echinococcosis; Hydatid cyst; Subcutaneous tissue