Abdulhakim Yildiz
Introduction
Hydatid disease caused by Echinococcus granulosus most commonly involves the liver and lungs, whereas primary soft tissue and subcutaneous involvement is rare. Scapular region localization is exceptionally uncommon and may mimic benign lesions such as lipoma or sebaceous cyst, making preoperative diagnosis difficult. Awareness of this entity is important in endemic regions to avoid unexpected intraoperative complications.
Methods
A 27-year-old woman presented with a slowly enlarging left scapular mass first noticed in July 2025, with subsequent increase in size and pain prompting referral. Physical examination revealed a mobile, well-circumscribed, soft subcutaneous lesion measuring approximately 4×4 cm. Preoperative imaging performed at an outside center demonstrated a septated cystic lesion on ultrasonography, an anechoic cystic lesion on Doppler ultrasonography, and a lesion reported as compatible with sebaceous cyst on magnetic resonance imaging. Thoracoabdominal computed tomography showed no additional pathology. Surgical total excision was performed under local anaesthesia.
Results
The lesion was removed completely without rupture or spillage. Histopathological examination demonstrated findings consistent with hydatid cyst, and a lipomatous tissue component was also identified within the same specimen. Albendazole therapy was initiated. Additional thoracic and abdominal imaging showed no other organ involvement, confirming primary isolated subcutaneous disease. No recurrence was detected during 3-month follow-up.
Conclusions
Primary subcutaneous hydatid cyst of the scapular region is extremely rare and may mimic common benign soft tissue masses. In endemic settings, hydatid disease should be included in the differential diagnosis of cystic or soft tissue lesions to guide safe surgical management and appropriate postoperative evaluation.
Authors
Abdulhakim Yıldız, Akdeniz University Faculty of Medicine, Department of General Surgery, Antalya, Turkey
Kübra Şimşek, Akdeniz University Faculty of Medicine, Department of Pathology, Antalya, Turkey
Muharrem Sarkın, Akdeniz University Faculty of Medicine, Department of General Surgery, Antalya, Turkey
Zeki Demirok, Akdeniz University Faculty of Medicine, Department of General Surgery, Antalya, Turkey
Muhittin Yaprak, Akdeniz University Faculty of Medicine, Department of General Surgery, Antalya, Turkey