Javed Iqbal Kazi ( Departments of Pathology & Surgery, Jinnah Postgraduate Medical Centre, Karachi. )
Asadullah Khan ( Departments of Pathology & Surgery, Jinnah Postgraduate Medical Centre, Karachi. )
Syed Raza-ur-Rehman ( Departments of Pathology & Surgery, Jinnah Postgraduate Medical Centre, Karachi. )
A 38 year old female presented with a painful lump in the lower and outer quadrant of left breast; the lump had grown in 3 months time. On examination the breast lump was firm mobile with regular outline and measured 4x3cm in size. Hydatid cyst, however, was not suspected till it was removed surgically in toto under local anaesthesia. On histology the laminated wall of cyst with germinal epithelium and many scolices were seen (Figure). X-ray of chest and ultra sound screening of liver and abdomen did not reveal hydatid cyst in any other órgan.
Hydatid antibodies done three months after the operation to find out if there was any other cyst in the body, were found to be negative. The post-operative period was uneventful and the patient was discharged after 2 weeks of the operation.
Once the Eechinococcus larva has passed through the liver and lung, it can settle anywhere in the body. According to Barret and Thomas1 60% are found in Liver, 30% in the Lungs, 2.5% in Kidneys, 2.5% in the Heart, 2% in the Bone, L5% in the Spleen, 1% in Muscle and 0.5% in Brain. Many workers have reported hydatid cysts in rare sites of the body. In 532 cases reported by Bickers2 one case each was located in the orbit, bladder, heart, chest wall, subcutaneous tissue, tibia, parotid and thyroid.
Review of the available literature has not yielded any case in breast. This case is even more unusual because it appears to be the only site in the body where this patient had a hydatid cyst.
We are thankful to Professor N.Aiafarey and Dr. Syed Mahmood Adam for their kind guidance.
1. Barrett, N.R. and Thomas, D. Pulmonary hydatid disease. Br. J. Surg., 1952; 40:222.
2. Bickers, W.M. Hydatid disease of the female pelvis. Mn. J. Obstet. Gynecol., 1970; 107: 477-