Challenges in Diagnosing and Managing Ovarian Hydatidosis: A Case Report and Literature Review from Iran.

Hydatidosis is an infection caused by the parasite Echinococcus granulosus (E. granulosus). The liver and lungs are the most commonly affected organs. However, ovarian hydatid cyst (OHC) is a relatively rare manifestation. Herein, we report a case of primary OHC in a 65-year-old woman. Additionally, upon review of reported OHC cases in Iran, a total of 13 cases have been documented in various studies, with our case being the second reported from Tehran. Most cases originated from different regions of Iran, except for the southwest and southeast, with an average patient age of 38 years. The predominant symptom was abdominal pain, and approximately 77% of the initial diagnoses were unclear. Notably, our patient represents the oldest reported case to date and presented with a right-sided OHC, a first reported in Iran. Gynecologists, radiologists, and pathologists should have a high degree of suspicion for hydatid cysts when evaluating septated cystic pelvic masses. To ensure accurate preoperative diagnosis, a combined approach using imaging, serologic tests, and clinical evaluation is recommended in endemic echinococcosis regions.