PMC8488500_01
Axial view of contrast-enhanced CT of the pelvis showing a large left, multicystic hydatid lesion with iliac bone destruction and extension to posterior soft tissue.. CT, computed tomography.
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At the first presentation to our unit 5 years ago, she had been initially referred to us by our gynaecology colleagues after a workup for a long-standing history of pelvic pain revealed a 7.5 x 6.7 x 8.8 cm [transverse (TV) x anteroposterior (AP) x craniocaudal (CC)] multiloculated cystic lesion in the left iliac fossa on computed tomography (CT) of the abdomen and pelvis (Figure 1).
Coronal view of contrast-enhanced CT of the abdomen and pelvis showing extent of (a) left pelvic, iliac bone destruction and (b) large pelvic, multicystic hydatid lesion causing compression on adjacent organs.. CT, computed tomography.
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Repeat CT showed a large thick-walled multicystic lesion in the left lower pelvis extending posteriorly into the gluteus muscle (Figure 2).
Preoperative CT 3D construction of left iliac bone destruction with sacroiliac joint involvement.. CT, computed tomography; 3D, 3-dimensional.
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Imaging also revealed significant lytic change within the left iliac bone resulting in extensive bony destruction of the left iliac wing and involvement of the sacroiliac joint (Figure 3).
Intraoperative photograph showing one of many daughter cysts within the extraperitoneal cavity and scolicidal soaked swabs around the operative site.
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Sterile swabs soaked in scolicidal agent (0.1% sodium hypochlorite solution) were placed around the cystic operative field (Figure 4).
Intraoperative photograph showing the bony fragments within the cavity resulting from extensive left, iliac bone destruction.
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The extraperitoneal cavity and bony fragments from the pelvic wing that were visualised intraoperatively were also debrided (Figure 5).