Case Report: Laparoscopic Excision of a Primary Giant Splenic Hydatid Cyst: Literature Review

An Isolated Hydatid Cyst of the Spleen with High Serum Levels of CA 19-9-A Meaningful Association or Just a Challenge for Diagnosis? A Case Report

An isolated hydatid cyst of the spleen represents an exceptional pathology, and its association with high CA 19-9 serum levels was not previously reported. This case presents a patient with an isolated hydatid cyst of the spleen, with preoperative high CA 19-9 serum levels in the absence of other pathologies and normalization of CA 19-9 serum levels after surgery (i.e., splenectomy). The source and clinical value of high serum levels of CA 19-9 in hydatid cysts of the spleen remains unclear. High serum levels of CA 19-9 in the context of a splenic cyst may complicate diagnosis and challenge the therapeutic strategy.

An unusual case of splenic hydatid cyst perforating into posterior wall of stomach

Hydatid disease (cystic echinococcosis) is a parasitic infection caused by Echinococcus granulosus. Hydatid cysts are typically found in the liver and lungs, but they can also rarely occur in the spleen. This case report describes an unusual occurrence of a splenic hydatid cyst that perforated the posterior wall of the stomach. The patient, a 55-year-old female, presented with severe pain in the left hypochondrium and nausea. A computed tomography (CT) scan revealed a large, complex mass in the spleen with multiple hydatid cysts and a perforation of approximately 5 × 5 cm into the stomach wall. The patient underwent peri-cystectomy for the infected splenic hydatid cyst and repair of the gastric perforation. Histopathological examination confirmed the presence of hydatid cysts. This case highlights the importance of considering hydatid cysts in the differential diagnosis of abdominal masses that erode into the stomach to prevent overtreatment and ensure an accurate diagnosis.

Spleen salvation: A successful case of spleen-preserving surgery for hydatid cyst

INTRODUCTION AND SIGNIFICANCE

Hydatid disease is a parasitic infection caused by tapeworm larvae that can affect different organs, including the spleen. While isolated hydatid cysts in the spleen are rare, they are usually asymptomatic and are frequently discovered incidentally. Treatment options depend on several factors, such as cyst location, size, and number.

CASE PRESENTATION

We present the case of a 9-year-old child who lives in rural areas. He was suffering from pain in the left flank for 3 months. An ultrasound and CT scan of the abdomen were performed. It was found that there was a solitary hydatid cyst in the spleen, about half the size of the spleen. Surgical intervention was performed and the cyst was completely removed without opening the cyst and with preservation of normal splenic tissue.

CLINICAL DISCUSSION

In cases of splenic cysts, the spleen must be preserved and the cyst must be removed with caution so as not to rupture it. Therefore, protecting the child from the possibility of hydatid cyst spread and anaphylactic shock.

CONCLUSION

In conclusion, this article underscores the importance of differential diagnosis of a hydatid cyst in the spleen and taking the necessary preventive measures before and during surgery to avoid the rupture of the cyst.

Minimally invasive spleen-preserving surgery to treat primary splenic hydatidosis: short and long-term outcomes: a cohort study

Background

Primary splenic hydatidosis, a rare manifestation of Echinococcus granulosus infection, presents unique diagnostic and therapeutic challenges. This study compares spleen-preserving surgeries with total splenectomy for treating primary splenic hydatid cysts, focusing on short- and long-term outcomes in the Jordanian context, a region particularly affected by this condition.

Methods

This retrospective analysis was conducted on 18 patients diagnosed with primary splenic hydatid cysts at two Jordanian hospitals from January 2015 to June 2021. Selection criteria included confirmed diagnosis and complete medical records. Surgical approaches, including laparoscopic partial splenectomy, cystectomy, and cyst deroofing, supplemented by albendazole therapy, were compared based on patient demographics, symptoms, surgical details, complications, and recurrence rates.

Results

The study group was composed of (n=7, 38.9%) male and (n=11, 61.1%) female patients, with an average age of 33.7 years. Most presented with left upper quadrant pain. Postoperative complications occurred in 22% of patients, with an 11% recurrence rate during follow-up. No significant statistical difference in recurrence rates was observed between spleen-preserving surgeries and total splenectomy. These findings highlight the efficacy of less invasive, spleen-preserving techniques in managing primary splenic hydatidosis, showing comparable outcomes to total splenectomy with minimal impact on recurrence rates.

Conclusion

Spleen-preserving surgery offers a viable alternative to total splenectomy in treating primary splenic hydatid cysts. This approach maintains immune functionality and reduces septic risks, especially in pediatric patients. The study underscores the importance of individualized treatment approaches and suggests further research with larger cohorts for more comprehensive insights into managing this rare condition. The limitations of this study include its small sample size and retrospective nature.

Primary isolated hydatid cyst of the spleen: A case report

INTRODUCTION AND IMPORTANCE

Primary (isolated) splenic hydatid cyst is rare and accounts for less than 2 % of hydatid patients, even in endemic regions. Diagnosis of splenic hydatid cyst can be challenging due to the rarity of the condition and its nonspecific symptoms. Surgery is the mainstay of treatment. This case report discusses management options for such a rare condition.

CASE PRESENTATION

We present a 33-year-old female patient with abdominal pain for six months and splenomegaly. Ultrasonography and CT scan showed a giant splenic cyst with clear walls and multi-vesicular contents suggestive of a hydatid cyst. There was no involvement of the liver or other organs. Indirect hemagglutination was positive for Echinococcus. Through a left subcostal incision total splenectomy was performed. The patient was discharged from hospital on the sixth postoperative day. No local recurrence was detected during postoperative follow up.

CASE DISCUSSION

Primary splenic hydatid disease is rare. It may be detected incidentally or present with nonspecific complaints. If untreated, a splenic hydatid cyst can lead to various potentially severe complications, including cyst rupture and secondary infection. Standard treatment is open total or partial splenectomy: preservation surgery should always be considered, to avoid post splenectomy infection, especially in young patients.

CONCLUSION

Primary splenic hydatid cyst is rare even in endemic areas. Symptoms may be non-specific. Standard treatment is open total or partial splenectomy.

A 16-year-old adolescent with a history of minor abdominal trauma diagnosed with a giant isolated primary splenic hydatid cyst: a case report

Introduction

Hydatosis is a zoonotic parasitic disease caused by echinococcosis larval infection. South America, Africa, the Middle East, South Europe, India, and Australia are endemic to this disease. Splenic involvement is a rare and complicated hydatid disease presentation. A splenic hydatid cyst is an infrequent clinical occurrence, even in regions where the disease is endemic.

Case presentation

A 16-year-old male, having a background of mild abdominal trauma and non-resolving dull abdominal pain attended a paediatric surgical outpatient office and following a thorough examination, was diagnosed with a giant solitary isolated splenic hydatid cyst. Subsequently, the patient received albendazole and underwent total splenectomy, necessitated by the considerable size of the cyst, classified as a giant.

Clinical discussion

Splenic involvement of hydatid disease is a rare presentation (0.5-8%.). With the initial clinical finding often involving the accidental discovery of a palpable mass, the most frequently reported symptoms and signs include the presence of a palpable mass, fever, dull pain, or splenomegaly. Ultrasound and computed tomography are the most helpful tools for evaluating focal splenic diseases. The preferred treatment involves the use of antihelminthic drugs such as albendazole or mebendazole in conjunction with splenectomy. Total splenectomy is the preferred approach and is associated with decreased hospital stay, reduced healthcare costs, and a lower likelihood of recurrence.

Conclusion

in endemic areas, in patients with splenic cysts, hydatidosis should be contemplated.

A massive primary hydatid splenic cyst was successfully managed through open total splenectomy: a case report and review article

Background

Cystic echinococcosis (CE) is a parasitic infection that is caused by the tapeworm Echinococcus granulosus. CE is very common, especially in the rural areas of developing countries. The most commonly affected organs by hydatid cysts are the liver and the lungs. However, the primary splenic hydatid cyst (PSHC) is a very rare manifestation of CE with an incidence of 0.5-8%.

Case presentation

A 17-year-old female patient presented with abdominal pain which gradually increased over months, along with anorexia and vomiting. Computerized tomography showed a massive splenic cystic mass. An open total splenectomy was performed. By follow-up, the platelet count and a postoperative chest X-ray were normal. The patient was prescribed Albendazole and analgesics. The pathological study confirmed the diagnosis of PSHC.

Conclusion

Despite the occurrence of PSHC being very rare, it is very important to take it into consideration, especially in endemic areas.

A case of giant primary splenic hydatid cyst: Case report

Introduction

Primary splenic hydatidosis is a rare zoonotic disease, common in grazing regions of the world. Primary splenic hydatid cyst is rare and accounts for <2% of patients. Splenectomy is advocated in case of giant hydatid cyst locating in central and hilum area; however, spleen salvaging operations are done in superficial cyst, cysts localized to one pole of the spleen or cysts that are unresectable due to extensive adhesions and in children.

Presentation of case

We present a case of 29-year male patient from rural areas presented with the complain of left hypochondriac pain and tenderness along with the history of farming and cattle raising. There was no other significant history.

Clinical findings and investigations

Physical examination showed mildly distended abdomen, mild tenderness over left hypochondrium. Routine laboratory investigations were sent. Ultrasound and CT scan of the abdomen showed giant splenic cyst measuring approx. 15 × 14 × 11 cm along with daughter cysts. Postoperatively, cyst was sent for histopathological examination.

Intervention and outcome

Preoperatively, vaccinations against Pneumococcus, Hemophilus influenzae and Meningococcus along with Albendazole (15 mg/kg/day) was given 2 weeks before the planned operation. Total splenectomy was performed and diagnosis was confirmed by histopathological examination. Albendazole was continued for 2 more weeks. Patient remains asymptomatic thereafter and regularly followed up in OPD basis.

Relevance and impact

Presence of isolated splenic cyst should raise suspicion for primary splenic hydatid cyst in endemic areas. Splenectomy versus spleen salvaging options should be analyzed and performed as per the indications. Splenic hydatid cyst is one of the rare clinical findings and there is very much high chance that it goes undiagnosed during the clinical practice. So, the main motive behind writing this article is to shed knowledge on basic approach to this splenic finding.

Laparoscopic splenectomy for solitary splenic hydatid cyst: Case report

Hydatid cyst disease is a parasitic disease caused by a type of tapeworm called Echinococcus. It is endemic to cattle-rearing regions of Africa, Asia, South Europe, the Mediterranean, the Middle East and Australia. The most common site of infection is the liver (75%). Involvement of the spleen is rare and occurs in 5% of the cases. Solitary splenic cysts are even rarer (0.5%-4%). We present a case of solitary hydatid cyst of the spleen in a 47-year-old woman. The cyst was asymptomatic and an accidental find on a full-body computed tomography after epileptic seizure and body trauma. The condition was treated successfully with albendazole, but the patient requested the cyst removed. Laparoscopic splenectomy was performed. The specimen was placed in an Endo-Bag and extracted. The patient recuperated well and was discharged on the post-operative day 5. Six months after the procedure, the patient has no complaints.

Total Splenectomy for a Giant Isolated Splenic Hydatid Cyst Compressing the Abdominal Viscera: A Case Report

Patient: Female, 49-year-old

Final Diagnosis: Echinococcus infection

Symptoms: Left upper quadrant abdominal pain

Medication:—

Clinical Procedure: —

Specialty: Surgery

Primitive isolated hydatid cyst of the spleen: total splenectomy versus spleen saving surgical modalities

Background

This study aims to describe the clinical features of the isolated primitive splenic hydatid cyst, discuss and compare the different surgical approaches of this uncommon disease.

Methods

This is a descriptive retrospective study carried out over a period of 7 years extending from January 2013 to December 2019 reporting eight cases of isolated primitive splenic hydatid cysts. Data were collected from the register of the general surgery department of the Jendouba regional hospital. Files concerning another associated hydatid localization were excluded. Four patients underwent total splenectomy and four of them underwent different spleen preserving surgical techniques including resection of the protruding dome, partial splenectomy and pericystectomy.

Results

The diagnosis was incidentally made in 50% of cases. The main other revealing complaints are pain in the left upper quadrant of abdomen in 25% of cases and a painless renitent mass in the same quadrant in only 12,5%. None of patients who underwent total splenectomy had fever or sings of postoperative sepsis. Compared to those who had total splenectomy, patients who underwent spleen preserving surgery had a longer average hospital stay (9 vs 6,25 days) related to post-operative complications including abscess in the residual cavity after protruding dome resection in one patient and post-operative haemorrhage in one patient.

Conclusions

The current case series argues in favor of total splenectomy, preferably by laparoscopic route whenever the technical platform allows it, associated with some specific peri-operative therapeutic measures. It seems to be the safest way that helps to avoid post-operative complications of spleen saving surgical modalities. These complications are usually difficult to manage in poor countries with limited technical resources. Total splenectomy guarantees at least a decreased hospital stay, reduced healthcare costs, and the absence of recurrence in highly endemic underdeveloped countries.

Primitive isolated hydatid cyst of the spleen: total splenectomy versus spleen saving surgical modalities

BACKGROUND

This study aims to describe the clinical features of the isolated primitive splenic hydatid cyst, discuss and compare the different surgical approaches of this uncommon disease.

METHODS

This is a descriptive retrospective study carried out over a period of 7 years extending from January 2013 to December 2019 reporting eight cases of isolated primitive splenic hydatid cysts. Data were collected from the register of the general surgery department of the Jendouba regional hospital. Files concerning another associated hydatid localization were excluded. Four patients underwent total splenectomy and four of them underwent different spleen preserving surgical techniques including resection of the protruding dome, partial splenectomy and pericystectomy.

RESULTS

The diagnosis was incidentally made in 50% of cases. The main other revealing complaints are pain in the left upper quadrant of abdomen in 25% of cases and a painless renitent mass in the same quadrant in only 12,5%. None of patients who underwent total splenectomy had fever or sings of postoperative sepsis. Compared to those who had total splenectomy, patients who underwent spleen preserving surgery had a longer average hospital stay (9 vs 6,25 days) related to post-operative complications including abscess in the residual cavity after protruding dome resection in one patient and post-operative haemorrhage in one patient.

CONCLUSIONS

The current case series argues in favor of total splenectomy, preferably by laparoscopic route whenever the technical platform allows it, associated with some specific peri-operative therapeutic measures. It seems to be the safest way that helps to avoid post-operative complications of spleen saving surgical modalities. These complications are usually difficult to manage in poor countries with limited technical resources. Total splenectomy guarantees at least a decreased hospital stay, reduced healthcare costs, and the absence of recurrence in highly endemic underdeveloped countries.