Unexplained subcutaneous swelling: Keep echinococcosis in mind! Report of two primary extrahepatic subcutaneous echinococcosis cases and literature review

Alveolar and cystic echinococcoses (AE and CE) are parasitic zoonoses, mainly affecting the liver. Primary extrahepatic localizations remain rare and are difficult to diagnose. We report two cases of primary subcutaneous echinococcosis and the largest literature review on the subject. The first case is an alveolar echinococcosis located in the forehead region and the second a cystic echinococcosis in the abdominal wall. To our knowledge, a primary AE location in the face has never been described before. Pre-surgical diagnosis was not made in these two cases. However, it is essential to apply specific measures, depending on the type of echinococcosis (AE or CE), to prevent parasitic dissemination and recurrence. In view of the cases presented here, prolonged albendazole can be a second-line alternative to a surgical strategy. Echinococcosis should be kept in mind for differential diagnosis of soft tissue lesions in any part of the body.