Primary retroperitoneal hydatid cyst in pancreatic head region

Primary Retroperitoneal Hydatid Cyst: A Diagnostic and Treatment Conundrum

Hydatid cysts are caused by accidental egg ingestion of the Echinococcus granulosus parasite. A 24-year-old female was admitted to our hospital for chronic left lumbar pain. Computed tomography (CT) and abdominal ultrasonography identified an 8/12 cm retroperitoneal cyst. The CT results coupled with enzyme-linked immunosorbent assay tests (positive IgG for Echinococcus granulosus) confirmed that the tumor was a hydatid cyst. Treatment consisted of preoperative chemotherapy with albendazole, intraoperative parasite inactivation, laparoscopic partial cystectomy, and drainage. The drain was removed after three days. Chemotherapy was maintained for two years after surgery. No relapse was observed at the six-month reevaluation. In this article, the diagnostic and therapeutic options and resources are discussed and compared with the published literature.

Primary retroperitoneal hydatid cyst with intraperitoneal rupture: a case report

Background

Hydatid disease is endemic in Mediterranean countries and most commonly occurs in the liver followed by the lung. A primary localization in the retroperitoneum is extremely rare.

Case presentation

We report the case of a 29-year-old Tunisian patient presenting with progressive left flank pain and skin urticaria. On abdominal ultrasonography and computed tomography scan, a ruptured retroperitoneal hydatid cyst was diagnosed, which was confirmed by positive hydatid serology. The treatment consisted of resection of protruding dome. The evolution was favorable. No local recurrence was detected during postoperative follow-up.

Conclusions

Primary retroperitoneal hydatid cyst is extremely rare and has uncommon presentation, but we should learn the keys to its diagnosis. In endemic regions, high suspicion for this disease is justified regardless of localization.