To the best of our knowledge, this is the first case report in the literature of a hydatid cyst of the chest wall masquerading as a cold abscess. The striking resemblance between tuberculous cold abscess and hydatid cyst of the chest wall clinically and radiologically forms a diagnostic dilemma, particularly in those with a history of tuberculosis. Introduction To the best of our knowledge, this is the first case report in the literature of a hydatid cyst of the chest wall masquerading as a cold abscess. Primary hydatid disease of the chest wall is extremely rare. The striking resemblance between tuberculous cold abscess and hydatid cyst of the chest wall clinically and radiologically forms a diagnostic dilemma, particularly in those with a history of tuberculosis. We present the case of a hydatid cyst of the chest wall which masqueraded as a cold abscess in a patient with history of tuberculosis. Case Report A 48-year-old female presented to the surgical outpatient clinic with a swelling on the left side of the chest wall, of 3 months' duration. Ten years back, she underwent an incision and drainage for a swelling at the same site .She had received antituberculous therapy for pulmonary tuberculosis twice in the past, 10 and 6 years back. There was no other significant past medical or surgical history. There was no history of close contact with pets/animals. On examination, there was an 8x6 cm, ovoid subcutaneous swelling on the left side of the chest wall, with a healed 6 cm transverse scar on the skin over the swelling. This swelling appeared to be fixed to the skin and the underlying ribs. There were no features of an acute inflammation. Her hematological and biochemical parameters were within normal limits, except for ESR, which was 30mm/h. She had an X-ray of the chest, which showed a well circumscribed dense lesion on the left side (figure 1).The Ultrasound scan of the chest (figure 2) reported the presence of fluid with mixed echogenic particles, representing a cold abscess.
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