Primary cyst hydatid of adrenal: A case report

Adrenal cysts are very rare lesions, especially with parasitic origin.Here, primary cyst hydatid of adrenal in a 51 years old woman whoconsulted with a left flonk pain, is presented and the literatureis reviewed. This revised version was published online in August 2006 with corrections to the Cover Date.     

Paraplegia due to recurrent multiple hydatid cyst of the spine: A case report

Recurrence after surgical treatment of hydatid cyst of the spine is extremely common. Preexisting fibrosis, fragility of the cyst wall, confluent cysts and proximity to vital structures makes radical excision difficult and repeated recurrences are inevitable. This case report describes a recurrent hydatid cyst presenting as three separate cysts in the dorsal spine in a middle-aged male. The extradural cyst caused paraplegia. The extraspinal cyst presented as an extrapleural mass in relation with the eighth, ninth and the tenth ribs near the costo-vertebral junction. The three cysts were resected en masse. Complete neurological recovery occurred with no recurrence at four years follow-up. Resection of the hydatid cyst en masse offers the best chance of cure and must be attempted in all cases. A prolonged chemotherapy should be administered in all cases.     

Primary multiple cerebral hydatid cysts

Primary multiple cerebral hydatid cysts are extremely rare: In this paper, an 8-year-old male patient who has one primary cerebral hydatid cyst in each cerebral hemisphere is presented. CT findings and operation are discussed. The literature is reviewed and the incidence of multiple cerebral hydatid cyst is compared with the published reports.     

Primary hydatid cyst of the root of the thigh: a case report and review of the literature

Hydatid disease of bone is a rare event, and it is characterized by a high diagnostic and therapeutic complexity. We report a case of primary hydatidosis of the proximal thigh involving both the soft tissues and the proximal femur in a 59-year-old man. It has been possible to establish the diagnosis only 8 years after the appearance of the first symptoms (painful swelling over the root of the left thigh), when the patient came to our institution after several investigations.     

Drainage of hepatic hydatid cyst with a surgiport

This article describes the safe and effective technique of hepatic hydatid cyst drainage.     

Endless story of a spinal column hydatid cyst disease: A case report

We describe a case of multifocal relapsing hydatid cyst following multilevel thoracic corpectomy and 360° instrumentation surgery. A 41-year-old male patient presented with cord compression and paraplegia due to a multiseptated cystic lesion at T10-11 level. The cyst was excised with a combined anterior and posterior approach and 360° stabilization was performed. The patient received albendazole for 1 year after the surgery.The patient presented with paraparesis 5 years after the surgery. Cystic lesions between C2-T1 and T10-11 were detected on the spinal MRI and the patient was operated with removal of the lesions on both levels and adjuvant local 20% hypertonic saline application. The patient received albendazole for the postoperative 6 months.After 3 months from the surgery, the patient’s paraparesis recovered. There was no recurrence after 2 years from the last surgery.     

Calcified cerebral hydatid cyst

A case of calcified cerebral hydatid cyst recently treated in our neurosurgical service is reported. The frequency of calcified cerebral hydatid cyst (CCHC) is less than 1% of cerebral hydatid cysts. A review of the literature disclosed 13 cases of calcified cerebral hydatid cysts. The clinical presentation and radiological findings are discussed. The present case is, to the best of our knowledge, the first case studied by computerized tomography.     

The management of hepatic hydatid cysts: Review of 94 cases

In this retrospective study, 94 patients operated for hepatic hydatid cysts were reviewed to compared the advantages and disadvantages of different operative techniques. The patients were divided into four groups according to the type of operation. Group I consisted of 33 patients with peripherally located small cysts, eligible for excision, who underwent cystectomy. Group II consisted of 28 patients with cysts smaller than 5 cm, not suitable for complete removal, who underwent partial cystectomy with capitonnage. Group III were 21 patients with cysts larger than or equal to 5 cm, not suitable for complete removal, who underwent partial cystectomy with omentoplasty. Infection and biliary communication were not seen in groups II and III. Group IV were 12 patients with infected cyst or intrabiliary rupture who underwent partial cystectomy with external drainage. In group IV, hospital stay was longer than in the other groups (P < 0.05). Group I had the shortest hospital stay (P < 0.05). Group IV had the highest morbidity and recurrence rates (P < 0.05). We concluded that cystectomy is the technique of choice in selected patients, as it is associated with low morbidity, low recurrence rates, and short hospital stay. Omentoplasty is preferred if cystectomy is not feasible. If there is biliary contamination and infection, external drainage, rather than omentoplasty, should be performed. Received for publication on June 24, 1997; accepted on Dec. 3, 1997     

Fibular hydatid cyst

Hydatid disease is caused by the tapeworm Echinococcus. Genus Echinococcus has different species including Echinococcus vogeli, Echinococcus granulosus and Echinococcus multilucularis. Echinococcus granulosus is the most common cause of hydatid disease in humans. This disease occurs either through direct ingestion of parasite eggs from contact with infected dogs or indirectly from the ingestion of contaminated water or food.Infestation of hydatid disease in humans most commonly occurs in the liver (55-70%), followed by the lungs (18-35%). Bone hydatidosis however is very rare (3%). We present herein a case of hydatid cyst of the fibula, which is an uncommon site for the occurrence of this disease.     

Lumbar intradural hydatid cyst. Case report

Hydatid disease is a serious public health problem in developing countries. Cerebrospinal localizations account for 1% of all cases of hydatid disease. The spino-radicular form is exceptional. We report a case of a 25-year-old women with cauda equina. Thoraco-lumbar MRI has showed an intradural process extending from L3 to L5, a low-intensity signal on T1 weighted images and a high-intensity signal on T2 weighted images, which were not enhanced after gadolinium injection. There was no vertebral involvement. After L3 L4 and L5 laminotomy and opening of the dura-matter, multiple vesicles were found scattered among the roots, with no adhesion to meninges or nervous structures. Total extirpation was easy. The outcome was marked by recovery of the motor deficit and sphincter disorders. This localization is serious but its prognosis is excellent if the diagnosis is made early enough to prevent cyst rupture and to allow total resection.     

Cardiac involvement of hydatid disease

Objectives|Echinococcosis is a serious health issue occurring in some geographical region of the world. Cardiac involvement is rare and early diagnosis and prompt surgical intervention are critical.Subjects and Methods: Six patients with cardiac hydatid cysts underwent surgical treatment in our institution between April, 1996 and March, 2002. Five of the patients were female and one was male. Average age was 40±5 years with a range of 19 to 72 years. Cysts were located in the right ventricular outflow tract in two patients, the left ventricular outflow tract in one, the right atrial in one, the right ventricular in one and the right atrioventricular groove in one. Five patients were operated on using standard cardiopulmonary bypass techniques, and one was operated on without cardiopulmonary bypass.Results: In the perioperative and the early postoperative period, no cardiac problems was observed. On control echocardiography, a ventricular septal defect was detected in one patient in the late postoperative period. The ventricular septal defect was repaired using standard cardiopulmonary bypass and was closed with a teflon patch. Patients were followed up for a mean period of 3.4±2.5 years. No mortality or recurrence was observed during the follow-up period.Conclusions: When hydatid cyst is diagnosed, the possibility of cardiac involvement should also be investigated. The treatment of cardiac hydatid cyst is surgical extraction of the cyst.     

Vertebral hydatid cyst infection (Echinococcus granulosus): a case report

Spinal echinococcosis is a rare but serious condition. Within bone tissue hydatid cysts enlarge by daughter cyst formation. The value of drug treatment in bone echinococcosis is questionable. The aim of surgery is therefore removal of all the cysts. The best way to achieve this is at the first operation early in the progress of the disease. An anterior or circumferential approach is generally required to give the necessary accessibility. Owing to diffuse spread of the infection within the bone and the canal, recurrence is common. If neurological deterioration occurs, reintervention is necessary.     

Arterial embolism caused by a ruptured hydatid cyst in the heart: report of a case

Cardiac hydatid cysts are extremely rare and, although patients may remain asymptomatic for many years or have only minor nonspecific symptoms, they are associated with life-threatening complications. We report the case of a 32-year-old woman with an acute arterial embolism caused by a ruptured hydatid cyst in the heart. An emergency operation revealed that the embolism originated from the left cardiac chamber caused by a cyst in the left ventricle. There were also three cystic lesions in the right lung. The patient underwent surgery to remove the hydatid cysts from the right lung on the 13th day after the first operation. Her postoperative course was uneventful and she was discharged from hospital on the 27th day after admission. Received: October 29, 2001 / Accepted: March 5, 2002 Reprint requests to: Y. ünlü, Atatürk Mah. Universite Loj, 38/8, 25170 Erzurum, Turkey     

Primary hydatid cyst of the scaphoid: case report

Hydatid cyst caused by Echinococcus granulosus is a parasitic disease that can affect different organs. It is difficult to diagnose and has a tendency to recur. Primary bone involvement occurs in 0.5% to 4.0% of all patients with hydatid cysts. We present a 31-year-old woman with a primary hydatid cyst in the left scaphoid. Despite the availability of advanced imaging and laboratory investigation modalities (such as magnetic resonance imaging and serological studies) to make an adequate differential diagnosis of a cystic lesion in our case, intraoperative clinical suspicion led to the diagnosis. This was followed by a successful outcome without recurrence after 12 months.     

Management of hydatid disease of the liver—10 years'' experience in a non-endemic area

The incidence of hydatid disease of the liver caused byEchinococcus granulosus in Austria, a nonendemic region in central Europe, is documented over a 10-year period. Since 1984, 28 patients (24 women, 4 men) with hydatid disease of the liver have undergone surgery in our department. A definitive diagnosis was established by combining serological tests (an enzyme-linked immunosorbent assay withEchinococcus multilocularis antigen and an indirect hemagglutination assay withEchinococcus granulosus antigen) and abdominal imaging (computed tomography scan and ultrasonography). Twenty-four patients (85.7%) had uncomplicated echinococcosis; in most of them (16) total closed pericystectomy was done. Four patients (14.3%) had complicated echinococcosis, suffering from intrabiliary rupture and spontaneous perforation into the peritoneal cavity, and in two of these patients (7.1%) pyogenic transformation, one with abscess perforation, occurred. Postoperative complications were significantly more common in patients with complicated echinococcosis and included two bile leaks (necessitating prolonged tube drainage), pleural effusion, atelectasis, and wound infection. One recurrence of hydatid infection due to previous spontaneous perforation required reoperation 4 years after the primary event. The low recurrence rate of uncomplicated echinococcosis (0%) over a mean period of 5.6 years and of 3.6% when peritoneal echinococcosis was included may be the result of the radical surgical technique employed.     

肝包虫外囊剥除术38例应用体会

目的 探讨肝包虫外囊剥除术治疗肝包虫病的疗效。方法 采用肝包虫外囊剥除术治疗38例肝包虫病患者。结果 患者术后恢复良好，无胆瘘、出血、感染等并发症。结论 肝包虫外囊剥除术治疗肝包虫病是一种合理而可行的新术式。     

Extravisceral primary hydatid cyst of the retroperitoneum

BACKGROUND: Hydatid cyst (HC) continues to be endemic in the Mediterranean countries, such as Turkey. Living in a rural area is an important risk factor for the disease. HC is most commonly seen in the liver and lungs, but retroperitoneal hydatid cyst is very rare. The objective of this study was to evaluate the clinical and radiographic findings and surgical treatment of this unusual lesion. METHODS: Between 1979 and 2004, 14 cases with primary retroperitoneal hydatid cyst were treated surgically at our clinic. RESULTS: Symptoms included flank pain in eight (57.1%) and palpable mass in six patients (42.8%). The cyst was located in the right retroperitoneum in seven patients (50%), left retroperitoneum in five patients (35.7%), retrovesical region in one patient (7.1%) and paravesical region in one patient (7.1%). Surgical approaches were right paramedian extraperitoneal approach in four patients, left paramedian extraperitoneal approach in two patients and midline transperitoneal approach in eight patients. Total pericystectomy was chosen as the surgical procedure in all patients except in five (35.7%), who had partial cystectomy for cysts located near the vital structures. There were no complications and mortality postoperatively. CONCLUSION: A primary HC of the retroperitoneum is a distinct clinical entity that must be considered when caring for a patient with a retroperitoneal mass in endemic regions. It should be treated after the diagnosis is confirmed without any delay because of secondary spillages due to perforations and other possible complications.     

Primary intracranial hydatid cyst in the interpeduncular cistern

Summary Cerebral involvement in hydatid disease occurs in 1–4% of cases. There are few documented cases in the literature of intracranial hydatid cysts in unusual locations such as pons and thalamus. In this report, a case of 33-year-old male with primary intracranial hydatid cyst in the interpeduncular cistern is reported. This is the first such case in the literature.