Isolated Renal Hydatid Cyst Misdiagnosed and Operated as a Cystic Renal Tumor

Isolated renal hydatid cyst misdiagnosed and treated as a cystic renal tumor: a diagnostic pitfall

Background

The hydatid disease is a parasitic infestation caused by the larval stage of Echinococcus granulosus. The renal location of this infectious disease is uncommon compared to hepatic or pulmonary ones. Most patients remain asymptomatic for years and hydatiduria is the only pathognomonic clinical symptom. We report a rare case of renal hydatid cyst misdiagnosed and treated as a renal tumor.

Case presentation

A 45-year-old woman with no significant medical or surgical history presented with left lumber pain with hematuria. Magnetic Resonance Imaging (MRI) displayed a left renal mass with cystic and solid components, showing discreet enhancement, classified as Bosniak IV. The diagnosis of renal malignant tumor was made. The patient underwent a lumbotomy. Intraoperatively, the mass was adherent to the perirenal fat and seemed to invade the adrenal gland. An enlarged left nephrectomy with surrenalectomy was performed. The gross specimen showed a superior polar renal cyst (9 × 7 × 6cm). The cyst had a thick wall and contained multiple internal smaller cysts recalling the appearance of the hydatid cyst. The microscopic study showed a cyst wall consisting of acellular eosinophilic laminated membrane lined by a thin germinal layer from which merge daughter cysts. This cyst wall is surrounded by a dense fibrovascular tissue with chronic inflammatory cells. The diagnosis of renal hydatic cyst was made.

Conclusion

Although the renal hydatid cyst is relatively rare, this diagnosis must be considered in patients with renal cystic masses, especially endemic countries. Preoperative diagnosis is challenging, especially in type IV cysts which can mimic a renal tumor and lead to overtreatment.

Isolated renal hydatid disease: laparoscopic approach to an uncommon entity (case report)

Hydatidosis is a parasitic disease, endemic in various parts of the World. It frequently involves liver and lungs and, rarely, other organs as well. Isolated renal hydatidosis is a rare entity that accounts for less than 3% of all hydatid cases. Surgery remains the mainstay of treatment. We hereby report a case of isolated renal hydatid cyst involving left kidney that was managed by laparoscopic approach.

Cystic echinococcosis in humans and animals in Egypt: An epidemiological overview

Cystic echinococcosis (CE), caused by the cestode Echinococcus granulosus (sensu lato), is a serious neglected zoonotic disease in many parts of the world, including Egypt. Thus far, the actual incidence of CE in the Egyptian population remains unknown. Infection with E. granulosus (s.l.) is common among stray dogs in rural and suburban areas owing to the spread of parasite eggs. Herein, we present an updated review of published data on the incidence of CE in humans and animals as well as the genotypes prevalent in Egypt. CE occurs in most parts of Egypt; however, available data are mostly from northern Egypt, particularly Cairo and Giza. In southern Egypt, the disease is likely to be underdiagnosed or underreported. A few risk factors were studied. In the Egyptian population, residency in rural areas, farming, and age were significant factors for acquiring CE. In livestock, age, sex and season have been associated with high prevalence of CE. Several genotypes have been identified among livestock (G1, G4, G5, G6 and G7) and humans (G1, G6 and G7). This literature review underscores the need for a precise national surveillance system to track CE distribution in humans and animals and design appropriate preventive and control strategies for this disease.

•

A review summarizing the epidemiological data for Echinococcus granulosus (s.l.) infections in Egypt.

•

Egypt is an endemic area for cystic echinococcosis in the human population and livestock.

•

Genotypes G1, G4, G5, G6 and G7 of E. granulosus (s.l.) were reported in Egypt.

•

A national surveillance system to track cystic echinococcosis in Egypt is needed.

Primary hydatid cyst looked like renal cell carcinoma: case report

Renal hydatid cyst is a rare disease comprising of about 2–3% of all locations. We present a case of renal hydatid disease in a 48-year-old female patient who presented with a history of left flank pain without fever or hematuria. Ultrasonography and computed tomography showed a 3-cm cystic lesion Bosniak IV occupying the mid-zone of the left kidney diagnosed as renal malignancy. Laparoscopic partial nephrectomy was performed, but the histopathological examination of the lesion revealed hydatid cysts. Isolated renal hydatid cyst is very rare, especially in developed countries and can be misdiagnosed as a renal cell carcinoma pre-operatively.