Imaging of her chest and brain was negative for extra-abdominal dissemination.

Surgical excision of the pelvic cyst and debridement of the abdominal wall:
Microscopic Description:

Specimen 1: Pelvic cyst. The sections show hydatid cyst, characterized by a laminated, acellular cyst wall containing a fibrinous inflammatory exudate with abundant neutrophils. Protoscolices are present within the specimen. No viable tissue is included in the specimen.

Specimen 2: Anterior abdominal wall. The sections show hydatid cyst, with features as described above (Specimen 1). No protoscolices are seen; a single refractile hooklet is present within the inflammatory exudate. No viable tissue is included in the specimen.

The waterlily sign of detached membranes is regarded as a transitional stage between active and inactive hydatid disease.