 Hello, my name is Dr. Akshya Aar, second year PG resident from Kalinga Institute of Medical Sciences, Bhuvaneshwar. The topic today is atypical presentation of cystic echinococcuses. Introduction. Phytatid disease is a zoonotic disease which is caused by the larvae of echinococcus. Liver is the most common organ involved and together with the lungs it accounts for 90% of the cases. Other sites of involvement are muscles 5%, bones 3%, kidneys 2%, brain 1%, spleen 1% and in rare cases spine 0.5% and soft tissues such as the breast 0.27% are also involved. The diagnosis is clear when typical radiological appearance is observed at the common sites of involvement. Complications may give rise to atypical appearances and these coupled with unusual localizations pose diagnostic difficulty. Here we describe a series of rare cases with atypically located primary hydratid disease. We describe the imaging findings in patients with atypically located primary hydratid disease. Methods. Three cases of atypical presentation of hydratid disease that were histopathologically proven were retrospectively studied. Coming to the first case, a 40-year-old woman presented with low backache associated with tingling and numbness of bilateral lower limbs for the past three months. There was no history of tuberculosis or any other chronic illness. On examination, the patient was conscious, alert, and aphrodite. There was no cranial nerve deficit. Neurological examination revealed hypotonia and decreased power in both lower limbs left, both and right. There were no cerebellar and manager science. Hematological investigations showed easing of pain. So here we can see a complex cystic lesion in the left paravirtual region with extension from the level of D10 superiorly to L1 inferiorly. The lesion appears to extend along the intervertible foramina at the D11 level and the seeds situated in the epidural space, displacing the tickle sac towards the rectum. This MRI shows presence of multiple cysts and membranes are noted within the lesion. There is associated mild cord edema and spinal ganastinosis, which is also noted. Here we can see compression of the tickle sac and spinal cord at D11 and D12 level. The lesion seemed to elevate the left crust of the diaphragm and avert the soiasis. This was the case of hydratid disease of its time. Elisa for hydratid cyst was negative. But after three weeks' course of albin-dissolve, 400 MvOD patient underwent surgery and histopathological examination was consistent with hydratid system. Coming to the second case, a 43-year-old lady had a diffuse dial aching and intermittent chest pain and was not aggravated by any activity. No history of breast trauma, nipple discharge, fever or no family history of breast cancer was present. On physical examination, a large palpable mass was identified within the right breast with regular borders. The nipple, aureola and skin are undramapolite. There was no palpable lymph node in the right axilla. The left breast and axilla were normal and systemic examination did not show any abnormality. All the hematological investigations went on. Mammography revealed a well-defined radiopic lesion with no evidence of taxification in the right lobe quadrant. Ultrasonic breast revealed anechoic cystic lesion with floating undulating membranes within with some echogenic material on right side at 7 to 9 o'clock position. 3CT thorax revealed low adenovating lesion with faintly enhancing wall, linear enhancing structures and small cysts within in right breast and lower lobe of left lung also showed a well-defined cystic lesion with daughter's cyst and membranes within. This was a case of hydratid disease of breast and lungs. Elisa for hydratid cyst was positive. So the patient was diagnosed as a case of hydratid cyst and treated with admittance. Coming to the third case, a 48-year-old female presented the complaints of fever, right upper quadrant pain, jaundice and itchy. Physical examination revealed tenderness in the epigastric region and right upper quadrant of the abdomen. Laboratory investigations showed deranged liver enzymes which would increase serum total bilirubin which was 5.1 milligram per deciliter. Direct bilirubin which was 3.5 milligram per deciliter. Serum GGT which was 117 international units. Serum glutamic pyruvic transaminase which was 152 international units. And Serum alkaline phosphatase which was 207 international units. Ultrasonic abdomen revealed enlarged liver and well-defined heteroechoic lesion with a caustic intense within completely involving the left lobe of liver with wall thickness of 2.6 under which showed floating membranes within. Lesion was seen compressing the gallbladder and the portability. Mild bilobar high HBRT was seen. Common bile duct appeared to be diluted. Elisa turned out to be positive for a hydratid. Here in the MR, we can see this was the case of a hepatic hydratid cyst with biliri conjugation. A well-defined T2 hyperintensistic lesion which is seen occupying the entire left lobe of liver. The cyst is communicated with the left hepatic duct, the dilated left hepatic duct and common bile duct which are measuring 13 m up and 13.7 m in perspective. There is internal floating membranes and peripheral calcium with foci within. Other multiple small size T2 hyperintensulations are scattered in the right lobe of liver, suggestive of endobiliary spread of hydratid cyst. Discussion. Hydratid disease is a zoonotic disease which is caused by the larval state of the system, the echinococcus. The life cycle involves definitive and intermediate worst by humans or the accidental worst. The forms of echinococcus which have medical relevance are echinococcus granulosis and echinococcus multilocularis. Sixth classification. Type 1 is a simple cyst with no internal architecture. Type 2 assists with dottocyst and matrix. In that has three subtypes. Type 2A which is round dottocyst at the periphery. Type 2B, larger irregularly shaped dottocyst occupying almost the entire volume of the muscles. Type 2C, oval muscles with scattered calcifications and occasional dottocyst. Type 3, calcified cysts and type 4, complicated cysts like ruptured cysts. Spine accounts for less than 1% of the cases. Thoracic spine is most frequently involved followed by the lumbar which is 20%, sacral 20% and cervical 10%. The cyst is usually located epidurally and rarely in intradural and extramedular location. It is usually confined to a single vertebral body owing to the relative resistance to the invasion of intervertebral space. No reinforcement is seen and calcification is also rare. There are many potential local complications such as intrahepatic complications, trans-tychromatic thoracic involvement, perforation into hollow viscera, portal vein involvement, abdominal wall invasion, and frank velary communication which has been reported in only 5 to 15% of the cases. It can also occur in the right duct in 55 to 60% of the cases, in the left duct in 25 to 30% and rarely in the confluence of the core in the duct bed. Breast-hydrated cyst is very direct. Diagnosis is difficult unless ultrasound reveals membranes of fluid level due to debris in the cyst. Breast-hydrated cysts and other organs adds to the diagnostic confidence. Lungus is the second most common site of involvement. Hydrated cysts can grow very last due to compressibility of lungs. In the absence of typical features, necrotic lung mass, metastasis, and intraparenchymal bronchogenic cyst should always be included in the differential diagnosis. Conclusion. Knowledge with atypical presentations and complications of hydrated disease may be helpful in making a prompt and accurate diagnosis, which aids in patient care. Thus, hydrated cysts should be included in the differential diagnosis and cyst diagnosis of a specific organ, even when the typical appearance of cyst with multiple doctasis is not seen. This is particularly important if the patient belongs to an endemic region and has cystic lesions in the liver or these are the references that we have used in the paper.