Hydatid Cyst Masquerading as Chronic Sialadenitis - An Extremely Rare Locale of Zoonotic Disease Demystified by Cytology

Sep 30, 2026

Hydatid cyst can present in an unusual anatomy, where embryos rarely escape hepatic and pulmonary vasculature to form lesions elsewhere. This case describes a tropical zoonotic infection that mimicked chronic sialadenitis at a rare submandibular site. A 35-year-old woman developed painful swelling for two months. Fine-needle aspiration cytology identified refractile hooklets, later confirmed by serology and histopathology. The report supports a careful, safe cytology-based diagnostic approach.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages4

Reading Time10 min

AccessFree to download

Abstract

Introduction

Case Report

Discussion

Conclusion

Keywords

Hydatid Cyst Masquerading as Chronic Sialadenitis-an Extremely Rare Locale of Zoonotic Disease Demystified by Cytology Kavita Gaur 1, Kiran Agarwal 1, *Gautam Bir Singh2, Poornima Kumar 1, Arun Krishna 1 Abstract Introduction: Hydatid cyst disguised as chronic sialadenitis, represents a highly unusual clinical presentation. Only rarely do hydatid embryos escape the hepatic and pulmonary vasculature to enter other organ territories. This report highlights a tropical infection hoodwinking clinical suspicion due to an unexpected rare anatomical site of appearance. The present case masqueraded as a comparatively innocuous chronic sialadenitis. In addition, previous work has debated the use of cytology in diagnosing hydatid cyst on the grounds of triggering anaphylaxis.If done carefully, however, rewarding diagnostic returns can be seen, as seen herein. Case Report: We present an extremely rare case of a 35- year -old female presenting with swelling in the submandibular region with pain for two months. Ultrasonography revealed a hypoechoic lesion with fine needle aspiration showing the presence of numerous refractile hooklets suggesting hydatid disease. The same was confirmed both by serological evaluation and subsequent histopathological findings. Conclusion: This report highlights a unique presentation of hydatid cyst presenting as chronic sialadenitis, hitherto unreported in medical literature. Furthermore, it documents a safe diagnostic course employing cytology to diagnose atypical echinococcal infections. Keywords: Hydatid cyst, Submandibular gland, Cytology Received date: 18 Nov 2024 Accepted date: 30 Apr 2025 *Please cite this article; Gaur K, Agarwal K, Bir Singh G, Kumar P, Krishna A. Hydatid Cyst Masquerading as Chronic Sialadenitis-An Extremely Rare Locale of Zoonotic Disease Demystified by Cytology. Iran J Otorhinolaryngol. 2025:37(6): 341-344. Doi:10.22038/ijorl.2025.81795.3829 1Assistant Professor, Lady Hardinge Medical College, Shaheed Bhagat Singh Marg, New Delhi, India. 2Department of Otorhinolaryngology & Head-Neck Surgery, Lady Hardinge Medical college, Shaheed Bhagat Singh Marg, New Delhi, India. *Corresponding author: 2Department of Otorhinolaryngology & Head-Neck Surgery, Lady Hardinge Medical college, Shaheed Bhagat Singh Marg, New Delhi, [India. E-mail: gbsnit@yahoo.co.in](India. E-mail: gbsnit@yahoo.co.in) Introduction Hydatid cyst is a zoonotic disease and is recognized as a health problem of global prominence. It is endemic in sheep rearing countries such as Australia, New Zealand, Middle East as well as Latin America & the Far East (1). These cysts are mostly seen in the liver and lungs. The submandibular gland is a very rare site for this lesion (2-4) . With this background, we present a case of hydatid cyst in the submandibular gland, wherein the clinical presentation was found to be interesting and hitherto unreported in the medical literature. In addition, this report also highlights the importance of fine needle aspiration cytology (FNAC) in the diagnosis of parasitic infections with rare site predilection. Case Report A 35-year-old female reported to the ENT outpatient clinic with complaints of swelling in the left submandibular region for one month with clinical symptoms suggestive of sialadenitis. The patient had pain in the submandibular region along with submandibular swelling while chewing food for the past two months and the swelling persisted. On examination a welldefined swelling measuring 3 cm in greatest dimension was seen in the left submandibular region (Fig 1a) . Fig. 1a: Clinical photograph of the patient showing a submandibular swelling. b: CT scan image [axial cut] delineating the hydatid cyst The swelling was firm in consistency and nontender. It would be prudent to note that the swelling was bimanually palpable. The patient was further investigated on the lines of chronic sialadenitis. Fine needle aspiration cytology (FNAC) and USG

FAQs

Why was the hydatid cyst presentation clinically confusing in this case?

It mimicked chronic sialadenitis, a comparatively innocuous condition, despite hydatid disease commonly involving the liver and lungs rather than the submandibular gland.

What diagnostic method provided the key cytology clue?

Fine needle aspiration cytology (FNAC) showed numerous refractile hooklets, supporting hydatid disease.

How was the diagnosis confirmed after cytology?

The presumptive diagnosis was supported by positive serological evaluation for Echinococcus and confirmed by subsequent histopathological findings.

Sep 30, 2026

Uploaded by supergirl