Orbital Hydatid Cyst in Pediatric Patients: Report of Two Rare Cases from Afghanistan

Orbital hydatid cyst is a rare manifestation of echinococcosis, comprising less than 1% of cystic echinococcosis. It most frequently affects the pediatric population and typically presents as a slowly enlarging orbital mass, causing progressive proptosis, restricted ocular motility, diplopia, and occasionally visual impairment. Hereby, we present two pediatric orbital cases from Afghanistan between 2021 and 2022, with one patient had right eye proptosis and diplopia: the other presented with left upper eyelid swelling and ptosis. Imaging revealed medial intraconal cystic lesions in both cases. Surgical excision via medial orbitotomy was performed; one cyst ruptured intraoperatively and was managed with scolicidal irrigation, while the other was removed intact. Parasitology and postoperative serology confirmed the diagnosis. Albendazole therapy was administered, and no recurrence was observed during 12- and 24-months follow-up. These cases underscore the importance of considering hydatid cysts in the differential diagnosis of orbital masses in endemic regions and highlight the role of early imaging and careful surgical management, and is particularly uncommon in children.