Extensive humerus and scapula hydatidosis: A unique case report and comprehensive review of management strategies

• Published in: International journal of surgery case reports 2024-12, Vol.125, p.110503, Article 110503
• Main Authors: Saberi, Sadegh, Naghizadeh, Hamed, Bagheri, Nima, Saffar, Hana, Afshar, Zeinab Mohseni, Khabiri, Seyyed Saeed
• Format: Article
• Language: English
• Subjects: Anthelmintic therapy; Bone hydatidosis; Case Report; Echinococcosis; Hydatid disease; Reconstruction; Scapula; Surgical management; Total humerus endoprosthesis
• ISSN: 2210-2612; 2210-2612
• DOI: 10.1016/j.ijscr.2024.110503

Bone hydatidosis is a rare manifestation of Echinococcus infection, presenting significant diagnostic and therapeutic challenges. This case report describes the successful management of an extensive hydatid disease involving the entire humerus and scapula. A 44-year-old male presented with progressive right arm pain and swelling. Imaging studies revealed extensive hydatid cysts throughout the humerus and scapula. Positive ELISA confirmed the diagnosis for anti-Echinococcus antibodies. Treatment involved a multidisciplinary approach. The patient received preoperative Albendazole for six weeks. The surgical intervention included total humerus endoprosthesis replacement and extended curettage of the scapula. Intraoperative scolicidal agent (povidone‑iodine) was used. Postoperative anthelmintic therapy was administered for three months. At five-year follow-up, the patient remained disease-free with satisfactory upper limb function. No recurrence was observed, although the patient declined further corrective surgery for prosthetic subluxation. This case highlights the efficacy of a comprehensive approach to extensive bone hydatidosis, combining wide resection, prosthetic reconstruction, and perioperative anthelmintic therapy. The successful outcome supports the use of total bone endoprosthesis in suitable cases of extensive long-bone hydatidosis. Long-term follow-up is crucial due to the risk of recurrence. •We described a unique case of extensive humerus and scapula hydatidosis.•Employed total humerus endoprosthesis and extended scapula curettage•Utilized preoperative and postoperative Albendazole therapy•Achieved disease-free status with functional limb at five-year follow-up•Demonstrated efficacy of multidisciplinary approach in bone hydatidosis