Hydatid disease is an endemic infection which has predilection to involve any organ, mainly the liver and the lung. When located at unusual sites like our case of primary ovarian echinococcosis, it is a great mimicker. Biopsy or aspiration of such lesions may cause devastating consequences like anaphylactic shock and spillage, requiring particular caution before any kind of intervention. Being familiar with imaging features of hydatid disease is essential in improving diagnostic accuracy and also preventing these adverse consequences. We report a case of primary ovarian hydatid cyst in postmenopausal women with suspected ovarian cancer. A 52- year- old woman complaining of abdominopelvic pain and weight loss was admitted to the gynecology department. The patient had tenderness and palpable left adnexial mass on vaginal examination. Ultrasound revealed hypoechoic heterogeneous mass with serpentine low reflections. CT was negative for other organ involvements. MRI revealed collapsed parasitic membranes as twisted linear structures within the lesion. This case report highlights one of the unique locations of primary Echinococcosis namely the ovaries and underlines the importance of imaging modalities in the differential diagnosis. Possibility of pelvic echinococcosis should be kept in mind in the pre- operative work up of ovarian masses especially in regions which are known to be endemic and in non-endemic geographic regions where immigrants are accepted.

Keywords: