Bahattin BAYAR, Muhammed Salih SÜER, Serkan DEMİR, Turgay SAYIN
Journal of Comprehensive Surgery - 2026;4(1):17-20
Hydatid disease, caused by Echinococcus granulosus, predominantly involves the liver and lungs; primary soft-tissue involvement is exceedingly rare. Cervical localization accounts for <1% of all reported cases. Because of its atypical anatomical site and nonspecific clinical features, diagnosis is challenging, and the lesion may easily mimic benign cystic masses. We present a rare case of a primary hydatid cyst located in the left posterior cervical triangle (Level V) of a 41-year-old woman from an endemic rural region in Eastern Anatolia, Türkiye. The lesion was excised en bloc under local anesthesia, which was deemed appropriate due to its superficial position and limited size. Intraoperatively, a thick-walled cyst was identified within the subcutaneous plane. A focal pericystic breach was noted; however, the cyst was removed without spillage, and the operative field was irrigated with hypertonic saline. Histopathological evaluation confirmed a fertile hydatid cyst. Postoperative thoracoabdominal imaging and serological testing revealed no visceral involvement. Given the complete excision without contamination and the absence of systemic disease, postoperative albendazole therapy was not initiated. No recurrence was detected during a ten-year follow-up period. Hydatid disease should be considered in the differential diagnosis of cystic neck masses, particularly in patients from endemic areas. When feasible, meticulous excision without cyst rupture can result in a sustained disease-free outcome. Long-term clinical and radiological surveillance remains essential. In selected patients, complete excision of a primary cervical hydatid cyst without spillage may achieve long-term disease-free survival even without adjuvant albendazole therapy. Careful surgical technique and structured follow-up are critical for success.
