|Year : 1978 | Volume
| Issue : 4 | Page : 48-49
Unilateral hydatid cyst of the orbit
IM Shukla, BS Sharva
Deptt. of Ophthal., Pt. J.N.M. Medical College, Raipur (M.P.), India
I M Shukla
Deptt. of Ophthal., Pt. J.N.M. Medical College, Raipur (M.P.)
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Shukla I M, Sharva B S. Unilateral hydatid cyst of the orbit. Indian J Ophthalmol 1978;26:48-9
Cases of orbital hydatid disease have been reported from different areas of world where hydatid disease is endemic. Highest incidence with unilateral proptosis has been reported from Iraq (19.8%). A few cases have been reported from India. This being a rare case of unilateral proptosis due to hydatid disease simulating lacrimal gland tumour is reported here.
| Case report|| |
A 25 years old female, village Labourer was admitted in the ophthalmic ward of Pt. J.N.M. Medical College and associated D.K. Hospital, Raipur (M.P.) on 7th Sept. 1977 with the complaints of having noticed presence of swelling in right eye near lateral canthus and gradual protrusion of right eye of 15 days duration. Patient did not complain of diminution of vision, pain and headache or diplopia. There was history of redness and watering in left eye about 4 months back which subsided.
Left eye was normal. Right eye, vision was 6/18, with widening of interpalpebral apperture. Eye ball was proptosed forwards and medially. A nodular nontender cystic swelling was present at upper temporal quardrant of orbit [Figure - 1]. Eye movements were restricted in all direction. Preauricular and submandibular glands were not enlarged. Fundus examination did not show any swelling of disc or engorgement of veins. Liver and spleen were not palpable Patient was carrying seven months pregnancy at the time of admission.
Urine examination:-Normal. Stool examination: No,mal. Hb. 11.5 gm %,E S.R.: 10 mm. at the end of 1st hour (Westergren J.L.C. 9500 cells per cms. D.L.C.: P. 60%, L. 38%, E. 2%, V.D.R.L.: Negative X ray of orbit and chest: Normal Mantoux test : Negative. Casoni's test: Negative,
Provisional diagnosis of lacrimal gland tumour of right eye was made.
Patient was put on antibiotics, anti-inflammatory drugs, vitamin C and B complex.
On 17th Sept. 1977 under local anaesthesia the exploration of patient's orbit was done (general anaes• thesia was not possible because of seven months pre. gnancy), through anterior orbitotomy approach. A cystic mass was found to be separate from lacrimal gland and was present in peripheral space of orbit, while dissecting it got ruptured and a clear white fluid came out, which was aspirated and the cyst wall was taken out in toto. Wound was closed with a small drain at outer canthus. Cyst wall was whitish and 2 mm. thick, Clinical diagnosis on the operation table was made as hydatid cyst.
During post operative period, patient was put on broad spectrum antibiotics, anti-inflammatory drugs, B. Complex and vitamin C orally. On 3rd postoperative day there was severe cellulitis around right eye extending upto temporal fossa with marked chemosis of conjunctive. Swelling subsided with antiallergic and anti-inflammatory treatment within 5 days. Stitches were removed on 7th postoperative day and patient was discharged on 30th Sept. 1977. There is no recurrence so far.
Histological report confirmed as a laminated wall of the hydatid cyst and aspirated fluid showed scolex of taenia echinococcus.
| Discussion|| |
Duke Elder reported 1% of all hydatid cyst in the orbit. Huilgol found the incidence of orbital cyst from 0.7 to 1 % of all orbital tumours. A small number of cases have been report from India.,,,,,
In the present case, history of association with dog and sheep could not be ruled out, as patient was a village labourer. The clinical diagnosis of lacrimal gland tumour was made as usual because of situation and clinical presentation. The casoni's test being negative and absence of eosinophilia in this case were further points against clinical diagnosis of hydatid cyst. Only surgical exploration could help in this case in diagnosis. The cyst although ruptured, while removing did not present much problem as reaction could very well be controlled by antiallergic and anti-inflammatory drugs.
| Summary|| |
A rare case of hydatid cyst causing unilateral proptosis in a female is presented here. The casoni's test was negative and the case clinically simulated lacrimal gland tumour.
| Acknowledgement|| |
We are very thankful to Professor S.S. Gupta, Dean, Medical College, Raipur, for permitting us to publish this case, and Prof. S. Agrawal, Deptt. of Pathology, for examining the specimen and confirming the diagnosis.
| References|| |
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[Figure - 1]