Primary Isolated Intramyometrial Cystic Echinococcosis Presenting with Life-Threatening Anemia.
Ignacio Cristóbal Quevedo, Oscar Torres Lantada, Miguel Rasero Ponferrada et al.
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Case in brief
A 29-year-old woman in northern Kenya presented with heavy menstrual bleeding and severe anemia. Ultrasound showed a 12 × 12 × 14 cm intramyometrial anechoic lesion, initially interpreted as a degenerating leiomyoma. Open myomectomy achieved intact excision without rupture. Histopathology demonstrated laminated acellular membranes and protoscolices, confirming cystic echinococcosis. Hepatic ultrasound and chest radiography showed no other organ involvement, supporting primary isolated intramyometrial disease.
What made this case unusual
The uterine cystic lesion was primary and isolated, rather than involving the more usual hepatic or pulmonary sites, and mimicked a degenerating leiomyoma on ultrasound.
Diagnostic / clinical pearl
In endemic settings, include cystic echinococcosis in the differential diagnosis of cystic uterine masses; preoperative suspicion may help avoid rupture and inform surgical planning.