Cystic echinococcosis of the thyroid gland in children and adults.

In humans, cystic echinococcosis is one of the most serious helminthic diseases worldwide. The larval stages (cysts) of Echinococcus granulosus are mainly located in the liver and the lung. Other locations of infection are rare, which may occasionally hinder its diagnosis. A 14-year-old girl from Kosovo presented with a cystic lesion in the left thyroid lobe of 4 years duration. Although two percutaneous punctures had been performed, she developed a recurrence and therefore had to undergo thyroid surgery. The results of the histopathologic examination revealed a hydatid cyst, and consequently, the patient received a long-term course of medication, namely, albendazole. Imaging of the cranium and chest were normal. A computed tomography of the abdomen detected a further cyst in the liver which did not show the typical signs of cystic echinococcosis. An echinococcus cyst in the thyroid gland is rare, especially in children. In a review of the literature published since 1965, only 12 children have been reported. Although by definition percutaneous drainage is contraindicated to avoid the spread of protoscolices, it is documented in eleven patients without complications. Surgical extirpation is mandatory. Chemotherapy with benzomidazole derivatives is necessary to avoid recurrence.