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ARTICLE
Year : 1968  |  Volume : 16  |  Issue : 2  |  Page : 101-102

Orbital hydatid cyst


Medical College Hospital, Nagpur, India

Date of Web Publication22-Dec-2007

Correspondence Address:
P P Ahluwalla
Medical College Hospital, Nagpur
India
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Source of Support: None, Conflict of Interest: None


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How to cite this article:
Ahluwalla P P, Agrawal R V, Padmawar B U. Orbital hydatid cyst. Indian J Ophthalmol 1968;16:101-2

How to cite this URL:
Ahluwalla P P, Agrawal R V, Padmawar B U. Orbital hydatid cyst. Indian J Ophthalmol [serial online] 1968 [cited 2019 Dec 11];16:101-2. Available from: http://www.ijo.in/text.asp?1968/16/2/101/37505

Hydatid cyst is one of the common­est parasitic affection in the tempo­rate climate of the World ((CHAR­TERJEE [1] ). Involvement of the orbit by a hydatid cyst though not very uncommon is rarely seen. It occurs preferentially in young people bet­ween 10 to 30 years of age; no defi­nite predilection for any particular site within the orbit has ben observ­ed, though upper and inner quadrant of the orbit is more com­monly affected. Orbital hydatid cysts are more common than intra­ocular cysts (SORBS). According to HUILGOL [3] the incidence varies from 0.7 per cent to 1 per cent of all orbital [7] tumor cases.

Clinical diagnosis of hydatid cyst in the orbit is extremely difficult, be­cause of its lack of characteristic pre­sentation. SVERDLICK [11] claims to be the first to diagnose clinically in­traocular hydatid cyst. Eyes at times have been removed due to mistaken diagnosis of absolute glaucoma (SOSRBY [9] ) or intraocular tumours. Eosinophilia and a positive Casoni's test are helpful in the diagnosis. His­tological examination is the only con­firmatory feature. Ideal treatment is extirpation of cyst without puncture. HANDOUSA [2] and TONJUM [11] are of the opinion that some portion of the fibrous pericyst be left during opera­tion to prevent post-operative enoph­thalmos.

Six cases of orbital hydatid cyst have been reported in literature since 1952 (MANZAR, [4] two cases; RAPA­PORT, [7] - one case; TENJUM, [11] one case; HUILGOL, [3] - one case; and ROY AND BANERJEE, [8] - one case).

Out of these, the last two case re­ports are from India.

The present paper deals with the clinical and histological findings in a case of hydatid cyst of the orbit.


  Case report Top


A Hindu female aged 30 years from Amravati District attended the hospital with the complaint of proptosis of right eye and dull type of headache on right side, of two months duration. There was no his­tory of injury or any association with cattle and dogs.

On examination the general build and health of the patient were satis­factory. Temperature, pulse and res­piration were within normal range. There was no lymph adenopathy. Liver and spleen were not palpable.

The right eye showed slight eccen­tric proptosis in the down and in qua­drant. The proptosis was not redu­cible. Fluctuation could not be eli­cited. The upper eye lid was tightly stretched [Figure - 1]. There was chemo­sis of both the conjunctiva. On ever­sion of the upper eye lid, the ante­rior lobe of lacrimal gland was pro­minently seen. Ocular movements were very much restricted in all dir­ections. The vision was counting fingers from I m. The fundus re­vealed papilloedema. Other systems were normal.

Investigations: Total leucocytic count -9,200/c.mm. Differential leu­cocytic count - Poly. -63%; Lymp­pho. -33% and Eosino. 3%. Haemo­globin 10 gms.%. X-ray of the orbit did not show any bony lesion.


  Operation Top


An anterior approach with lateral extension was performed. In the superior quadrant, a thick fibrous con­densation was seen. On incising the fibrous mass, an egg white cyst of nearly 2.5 cm. in diameter, was seen. The cyst was deep in the orbit ex­tending upto the apex and it leaked during its removal. The entire cyst with its surrounding fibrous mass was removed. Unfortunately the lateral rectus had to be severed during the operation.

The fluid from the cyst revealed presence of scolics. Histologically the diagnosis of hydatid cyst was con­firmed. [Figure - 2].

Post-operatively, the patient had mild local anaphylactic reaction which was treated and controlled. On discharge the patient's ocular move­ments, and vision had improved; the papilloedema had subsided, no enoph­thalmos was observed.


  Discussion Top


The maximum number of cases of hydatid disease from Vidarbha region showed lung, liver and spine to be the common sites of affection (NI­GAM AND GHARPURE, [4] MOKA­DAM [5] ). The present case is also from the same district, thereby suggesting the possibility of high incidence of Echinococcus granulosus infection amongst dogs in the district.

Close contact with dogs was found in only 55 per cent of the cases (MOKADAM, [5] ). In the present case also there was no history of contact with cattle or dogs. In such cases, ingestion of hexacanth embryo from polluted water supply with excreta of dogs is suggested. This is the first case report of orbital involvement from Vidarbha region.


  Summary Top


First case report of orbital hydatid cyst from Vidarbha region in a mid­dle-aged Hindu female is reported with its clinical and histological stud­ies. A brief review of literature on the subject has been made.

 
  References Top

1.
CHATTERJEE, K. D. (1952): Human Parasites and Parasitic Diseases. Cal­cutta. p. 666-78.  Back to cited text no. 1
    
2.
HANDOUSA, B. (1951): Am. Jr. Oph­thal. 35: 606-613.  Back to cited text no. 2
    
3.
HUILGOL, A. V. (1963): Jour. All ­India Ophthal. Soc. 11: 78-81.  Back to cited text no. 3
    
4.
MANZAR, M. (1954): Brit. Jour. Oph­thal. 38: 753.  Back to cited text no. 4
    
5.
MOKADAM, A. D. (1967): Thesis for M. S. (General Surg.) Nagpur Univer­sity.  Back to cited text no. 5
    
6.
NIGAM, R. AND GHARPURE, V. G. (1954): Ind. Jour. Surg. 16: 85-86.  Back to cited text no. 6
    
7.
RAPAPORT, M. (1957): Quoted by Ref. No. 10.  Back to cited text no. 7
    
8.
ROY, BANERJEE and others (1967): Jour. All-India Ophthal. Soc. 15: 35-37.  Back to cited text no. 8
    
9.
SORSBY, A (1963): Modern Ophthal­mology, Vol. II - Systemic Aspects. Lond., Butterworths, p. 251.  Back to cited text no. 9
    
10.
SVERDLIC J. (1961): Am. Jour. Oph­thal. 52: 981.  Back to cited text no. 10
    
11.
TONJUM, A. M. (1962): Acta Oph­thal. 41: 445-448.  Back to cited text no. 11
    


    Figures

  [Figure - 1], [Figure - 2]



 

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