I. Imaging Findings

Based on the provided CT images, the following findings are noted:

• Multiple cystic or cystic-solid mixed-density lesions are observed in the right buttock, right thigh, and calf region. They have relatively well-defined boundaries and septations. Some lesions show multiple compartments, resembling “multiple cystic vesicles.”
• The lesions overall exhibit a cystic nature without obvious calcification or significant enhancement. Mild compression or displacement of adjacent muscles and soft tissue is noted.
• No obvious bone destruction or changes in bone density are identified.

In summary, the imaging suggests multiple cystic lesions in the right buttock and lower limb, predominantly in a multi-compartmental form. The morphology and septations indicate a high likelihood of parasitic cysts (especially echinococcosis).

II. Potential Diagnoses

1. Soft Tissue Echinococcosis (Hydatid Disease)

   These lesions often present as multi-chamber or cystic changes. While echinococcosis is less common in muscle and soft tissues, it can occur. Clinically, it may appear as a painless mass. Considering the regional epidemiology and the multiple chamber cystic appearance, this is a highly possible diagnosis.

2. Lipoma or Liposarcoma with Cystic Degeneration

   Some lipomas or liposarcomas can undergo cystic changes, presenting with cystic components on imaging. However, typical features would include some fatty density. Multiple and extensively septated lesions are less common in this scenario.

3. Other Cystic Tumors or Lymphangioma

   For example, lymphangioma (lymphatic cyst) can appear as multi-chamber cystic structures, often found in superficial or lymphatic pathways. In atypical cases, it should be considered in the differential diagnosis from parasitic cysts.

III. Most Likely Final Diagnosis

Based on the patient’s history (slow progression, no significant pain) and the imaging features (multiple multi-chamber cystic lesions), and given that echinococcosis commonly presents with multi-chamber cystic manifestations, the most likely diagnosis is soft tissue echinococcosis (hydatid disease of the muscle or tendon). If confirmed by clinical examinations and laboratory tests (e.g., serology) or pathology, this diagnosis can be definitively established.

If imaging and serological results remain inconclusive, a biopsy through aspiration or surgical procedure is recommended to rule out other rare cystic tumors.

IV. Treatment and Rehabilitation Plan

1. Treatment Strategy

• Antiparasitic Medication: Commonly, albendazole is used before and after surgery to reduce cyst viability and prevent parasite spread.
• Surgical Intervention: For larger or multiple cysts threatening local tissue or organ function, surgical resection or drainage may be considered. Care should be taken to prevent spillage of cystic fluid during the procedure to avoid secondary implantation.
• Minimally Invasive Procedures: Where appropriate and if surgical risk is high, interventions such as saline or absolute alcohol injection and aspiration may be attempted, but require comprehensive evaluation.
• Postoperative Follow-up: Regular imaging follow-up using CT or ultrasound is recommended to monitor recurrence or changes in the lesion.

2. Rehabilitation/Exercise Prescription

After surgery or treatment, patients often need gradual recovery of local muscle strength and joint mobility. A stepwise rehabilitation program is recommended:

• Early Phase (1-2 weeks postoperatively):
  • Focus on wound care and basic limb movements, avoiding large or high-intensity activities.
  • Engage in passive or mild active range-of-motion exercises (e.g., slight flexion and extension of the hip and knee joints).
  • If pain is severe, supportive devices or braces may be used to prevent secondary injury.
• Mid Phase (3-6 weeks postoperatively):
  • Under the guidance of a physician or physical therapist, perform low-load resistance exercises such as seated leg raises or light resistance band workouts to restore muscle strength.
  • Gradually increase the frequency and intensity of exercises to about 15-20 minutes per session, 3-4 times a week.
• Late Phase (6 weeks and beyond postoperatively):
  • Once the lesion is healed and stable, further strengthen core and lower limb muscles. Light barbell squats or wall squats can be considered if feasible.
  • Use progressive loading and coordination exercises (e.g., lower limb balance training, single-leg stands) to enhance overall function.
  • Each training session can be extended to around 30 minutes, 3-5 times a week, adjusted according to individual tolerance.

Throughout the rehabilitation process, regularly assess muscle strength, joint mobility, and pain levels. Adjust the rehabilitation plan as needed to prevent overexertion or injury to adjacent tissues.

V. Disclaimer

This report is a reference analysis based on the existing imaging and patient history. It should not be used as a substitute for face-to-face consultation and treatment planning with a qualified medical professional. Specific diagnostic and therapeutic procedures should be determined following further examinations and specialist opinions.