Primary pelvic hydatid cyst occurs through hematogenous or lymphatic route. Adolescent female presented with complaints of suprapubic discomfort and constipation. Imaging revealed a cystic lesion in pouch of Douglas and removed surgically. This case emphasizes considering hydatid disease as a differential diagnosis of cystic pelvic mass, especially in the endemic regions.

Hydatid disease is found in many low-income countries, where humans are deemed accidental hosts. Bone hydatid disease is a rare entity as the lungs and liver are usually the target organs. However, there are currently a handful of case reports around the world with bone hydatid disease.
UNASSIGNED: We present South Africa\'s first case report of pelvic hydatid disease and looking to uncover some treatment options for this patient.

Hydatid disease (HD) is a commonly occurring zoonotic disease caused by tapeworms of the genus Echinococcus. It is endemic in many parts of the world and can involve almost any organ of the body. Although HD of the liver and lungs is quite common, ovarian involvement is rare. We present a case of a 24-year-old female patient who was diagnosed with multifocal hydatidosis involving the liver and bilateral ovaries on imaging. Postoperative histopathology confirmed the hydatid disease in the liver and one ovary. However, the cystic lesion in the other ovary turned out to be a borderline serous cystadenoma. This case highlights the limitation of imaging in differentiating between simple hydatid cysts and serous cystadenomas of the ovaries. Another point we learnt is that even in the presence of multifocal hydatidosis in endemic regions, serous cystadenoma needs to be considered in imaging differential diagnosis.