A 13-year-old woman, with rural residence in the IX region.
She presented with progressive right claudication on gait, highlighting a radiolucent image in the pelvic X-ray with sclerotic margins in the right iliac wing, with a primary bone tumor.
The pelvis CT scan showed an extensive osteolytic lesion with disorganized displacement of bone fragments that compromised the right iliac bone and the presence of a tumor lesion of liquid appearance up to 6 cm in diameter.
Biopsy of the tumor lesion was performed giving rise to abundant hydatid whitish membranes along with transparent fluid rock water compatible with pelvic hydatid disease.
Treatment was initiated with albendazole completing five cycles.
Complete blood count revealed increased eosinophils (5%) and positive for IgG and negative for IgE hydatid disease.
Dissemination study was completed with brain CT, abdominal ultrasound and chest X-ray not identifying cystic lesions.
In subsequent controls, the patient had persistent pain and claudication with greater involvement in joint mobility; the imaging study showed progression of the lesion with extensive bone destruction.
He was evaluated in Santiago and Argentina by multidisciplinary teams considering hemipelvectomy as a therapeutic option.
During her evolution the patient presented fever and abdominal distension compatible with an abdominal ultrasound showing a heterogeneous mass with free fluid in the right iliac fossa with abscess secondary to hydatid etiology.
Surgical drainage was performed and antibiotic treatment was initiated by culture positive for E. coli.
In the last CT and MRI of the pelvis cystic lesions were observed around the common iliac vessels and in front of the sacrum; the right iliac bone was completely compromised along with the sacro-iliac and coxo-femoral ramus.
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Currently, the patient has palliative pain management and evaluates the possibility of undergoing the proposed surgery.
