Orbital hydatid cyst
A 42-year-old female patient presented with headache gradually worsening, right eye swelling increased and visual deterioration. The swelling was not responded to systemic antibiotic. There was no history of trauma or systemic disease [Figures and ].\nOn examination there was proptosis of the right eye, the globe was displaced medially and inferiorly, and there was significant lid edema. Ocular movements were restricted in all direction especially in abductions. Visual acuity was reduced to finger counting at 1 feet with accurate projection of light.\nThe mass was nontender, irreducible, nonpulsative, no bruits audible, and was felt in lateral aspect of the orbit; posterior limit of the mass could not be reached. There was chemosis of both the conjunctives; on the upper eyelid eversion the anterior lob of the lacrimal gland was prominently seen. The fundus revealed papilledema.\nA magnetic resonance imaging (MRI) revealed a well-defined cyst lesion sized 25 × 25 × 30 mm located lateral to the right orbit []; the cyst appeared as a low-intensity signal on T1-weighted images and as a high-intensity signal on T2-weighted images, after an IV injection of gadolinium ethoxybenzyl diethylenetriamine pentaacetic. Acid-enhanced magnetic resonance imaging findings of borderline lesions exhibited capsular contrast enhancement on T1-weighted images.\nA chest radiography and abdominal ultrasonography showed no hydatid cyst. The diagnosis was intraorbital hydatid cyst. The patient informed in detail about all the possible intraoperative or postoperative complications.\nThe patient underwent surgery via a right lateral Rhinotomy approach. The patient was anesthetized via an orotracheal route and was positioned supine with the neck hyperextended and turned 30° toward the surgeon. The cyst was removed completely without rupture, and the wound was washed with normal saline. The wound was reapproximated with sutures. A systemic oral albendazole 200 mg was administered for 2 months after surgery for prevention. The patient recovered without complications.\nThe histopathologic report HE confirmed the hydatid cyst [].\nThe patient's postoperative course was uneventful, and she was discharged on the third postoperative day []. Eight months after surgery the patient was doing well and her ocular motility and vision had improved. On physical examination, no enophthalmos or proptosis was detected. Follow-up MRI revealed no evidence of the cyst.