Primary Hydatid Cyst in Adrenal Gland: A Case Report

The hydatid cyst of the adrenal gland is extremely rare pathology of the adrenal gland; here we report an adrenal hydatid cyst that presented as a solitary renal tumor.     

Spinal Hydatid Cyst Mimicking Arachnoid Cyst on Magnetic Resonance Imaging

Abstract

Background: Primary spinal hydatid cysts are uncommon and account for 1% of all cases of hydatid disease. Echinococcus granulosus is most often responsible for the cyst hydatid. Intradural, extramedullary involvement is rare. When the cysts do not demonstrate typical magnetic resonance imaging findings, the differential diagnosis is more complex.

Method: Case report.

Findings: An isolated primary hydatid cyst of the spine in a 35-year-old man that appeared to be an arachnoid cyst on preoperative radiographic examination.

Conclusion: Hydatid cysts that lack the typical radiographic appearance may be mistaken for arachnoid cysts. Misdiagnosis has serious implications for surgical intervention and long-term care.     

Hydatid Cyst of the Breast

Cystic hydatid disease is caused by the Echinococcus granulosus parasite. Most frequently, cysts develop in liver and lung. The breast is rarely a primary site of the hydatid cyst. A case of hydatid cyst of the breast is presented, the diagnosis of which was missed both pre-operatively and intra-operatively.     

Pulmonary hydatidosis: clinical profile and follow up from an endemic region

OBJECTIVES: The aim of this case series was to study the clinical presentation, treatment and outcome of pulmonary hydatid cyst disease at a tertiary care centre. METHODS: A retrospective review of case records was carried out to collect demographic, clinical and outcome data on patients with pulmonary hydatid disease, treated over a 10 year period. RESULTS: A total of 49 cases were included in the series. The most common presenting complaint was cough. Twenty-four per cent had bilateral lung involvement whereas 38% had both lung and liver involvement. Surgery was carried out in 38 cases. Surgical treatment was supplemented by pre-op and post-op chemotherapies. Muscle-preserving thoracotomy and cystectomy were most commonly carried out. Nineteen (39%) patients had post-op complications; however, there was no death. Ten patients were lost to follow up. Mean follow up was for 18 months without any recurrence. CONCLUSION: Pakistan is an endemic area for the disease. The patients in our series were relatively younger as compared with those in other reports. Surgery is the treatment of choice for hydatid disease and has good results. Pre-op and post-op chemotherapies decrease the risk of intraoperative infection and recurrence. Chest X-ray and abdominal ultrasound should be carried out in case of even minimum clinical suspicion, especially in endemic areas.     

Primary Spinal Intradural Extramedullary Hydatid Cyst in a Child

Abstract

Background/Objective: Spinal hydatid cyst is a serious form of hydatid disease affecting less than 1% of the total cases of hydatid disease. We present a case of pathologically confirmed primary intradural spinal cyst hydatid in an otherwise healthy patient who showed no other evidence of systemic hydatid cyst disease.

Case Report: An 8-year-old boy presented with back pain, left leg pain, and difficulty in walking. The patient had no other signs of systemic hydatid cyst disease. An intradural extramedullary cystic lesion was identified with magnetic resonance imaging and was shown to be a hydatid cyst by histopathologic examination after the surgical removal.

Conclusion: Although extremely rare, primary intradural extramedullary hydatid cyst pathology might be the cause of leg pain and gait disturbance in children living in endemic areas.     

Pleural Empyema as a Late Complication of Liver Cystectomy for Hydatid Cyst

Cystectomy without capitonnage is a widely used surgical technique for liver hydatid disease. A residual cavity can be left during the procedure, which can turn into an abscess. We report the case of a patient who developed right pleural empyema as a late complication of this procedure. She was successfully managed with antibiotics and a right thoracotomy.     

Comparison of pulmonary hydatid cysts in children and adults

BACKGROUND: The purpose of the present study was to compare the clinical features and the surgical approaches of the pulmonary hydatid cysts in children and adults. METHODS: One hundred and thirty-four patients, operated on for pulmonary hydatid cysts over the last 10 years were retrospectively evaluated in two groups: 39 children who were younger than 18 years old (29%) and 95 adults (71%). The patients in each group were analysed according to their clinical, radiological and surgical findings. RESULTS: The frequency of pulmonary hydatid cysts in children was significantly higher in boys (74%) than in girls (26%). However, there was no sex tendency in adults (52% in male vs 48% in women). The sex difference in hydatid cyst frequencies between adults and children was significant (P < 0.05). Among preoperative pleural complications, pneumothorax (15.5%) in children and empyema (11%) in adults were more frequent. The frequency of concomitant hepatic cysts was less in children than in adults (33%vs 79%). Huge pulmonary cysts (=10 cm) were more common in children (31%) than in adults (22%). Cystotomy with capitonnage was the most frequently preferred method in both groups. Postoperative complications developed in six children (16%) and 19 adults (19%), and were more frequent in patients with huge cysts (27%vs 16%). No recurrence was observed in both groups. CONCLUSIONS: Isolated pulmonary cysts are more common in children than adults. The cysts also tend to be bigger in children than adults. The frequency of concomitant hepatic cysts is less in children. Because of higher lung expansion ability and improvement capacity in children, resection should be avoided and lung saving surgical procedures should be performed. In spite of differences observed in the clinical features it does not change the treatment of pulmonary hydatid cysts in children.     

Primary Multilocular Hydatid Cyst of Neck with Unique Presentation: A Rare Case Report and Literature Review

Hydatid cyst (HC) is a parasitic infection caused by larva form of Echinococcus. It occurs frequently in liver and lungs. Primary HC of neck is extremely rare occurrence and here we report it with unusual presentation. A 35-year-old male presented with slowly growing painless swelling in right side of neck for 6–7 years. The swelling measured 11 × 6 cm and cough impulse elicited on local examination. MRI scan revealed a multiloculated cystic lesion in neck. Fine needle aspiration cytology yielded fluid aspirate and smear showed fragment of laminated membrane, suggestive of HC. The intact cyst was removed surgically and histopathologic examination confirmed the diagnosis of HC. Both clinicians and radiologists should consider HC in differential diagnosis of head and neck swelling for proper management.     

Secondary gallbladder hydatidosis and nonfragmanted germinative membrane sourced obstructive jaundice caused by intrabiliary ruptured hepatic hydatid cyst (a case report): two rare complication of the intrabiliary ruptured hepatic hydatid cyst

Intrabiliary rupture is the most frequently seen complication of the hepatic hydatid cysts. Obstructive jaundice can be seen as a complication of the intrabiliary ruptured hepatic hydatid cysts due to the migrated cystic content into bile ducts. In this study, we present two rare complications seen in a patient who has intrabiliary ruptured hepatic hydatid cyst. Obstructive jaundice and secondary gallbladder hydatidosis depending on to the intrabiliary ruptured hepatic hydatid cyst in a 58-year-old man patient were diagnosed and treated. A large choledochal nonfragmanted germinative membran was found in the choledochus as the reason of biliary obstruction. Hepatic hydatid cyst is a world-wide disease. Intrabiliary rupture must be kept in mind in the patients who has hepatic hydatid cyst and biliary tract problems.     

Primary Hydatid Cyst of Vastus Lateralis Muscle

Musculoskeletal system is rarely involved by hydatid cyst, the larval form of Echinococcus Granulosus. A 37-year old man was diagnosed as having a cystic mass within his left thigh musculature. Preoperative computerized tomography suggested an unusual location of echinococcus although serology could not confirm the diagnosis. During surgery, a white coloured cyst within left vastus lateralis muscle was enucleated. Pathological examination after removal of the mass revealed hydatid cyst of vastus lateralis muscle. This case emphasizes that hydatidosis should be included in differential diagnosis of any soft tissue mass especially in regions where it is endemic.     

Primary spinal extradural hydatid cyst in a child: case report and review of the literature

Spinal hydatid cyst is a rare but serious condition. An 8-year-old boy presented with back pain, progressive weakness and numbness in both legs. Magnetic resonance imaging (MRI) of the lumbar region showed a cystic lesion with regular contour located in extradural space. There was cerebrospinal fluid- (CSF-) like signal intensity on T1- and T2-weighted images. The lesion had excessively compressed the dural sac and caudal roots, and expanded to the L3 and L4 neural foramina. The case was explored with L2, L3, L4 laminectomy and the hydatid cyst was removed totally. The clinical presentation, diagnosis and surgical treatment of this rare case of spinal hydatid disease is discussed, and all available cases of primary extradural hydatid cyst reported in the literature are presented.     

Efficacy of Myrtus communis L. to Inactivate the Hydatid Cyst Protoscoleces

Purpose: The present study aims to investigate the scolicidal effects of Myrtus communis L. essential oil against protoscoleces of hydatid cysts and also its toxicity in mice model. Materials and Methods: Protoscoleces were aseptically aspirated from sheep livers having hydatid cysts. Various concentrations of the essential oil (12.5–100 μl/ml) were used for 5–30 min. Viability of protoscoleces was confirmed using eosin exclusion test (0.1% eosin staining). Moreover, 48 male NMRI mice were used to determine the acute and sub-acute toxicity of M. communis essential oil. One-way ANOVA with Tukey's post-hoc test was used to assess differences between experimental groups. Results: Findings of the present study demonstrated that the M. communis essential oil at the concentration of 100 μl/ml after 5 min of exposure killed 100% protoscoleces. Similarly, the mean mortality rate of protoscoleces after 10 min of exposure to concentration of 50 μl/ml was 100%. However, lower concentrations (12.5 and 25 μl/ml) of M. communis essential oil provoked a delayed protoscolicidal effects. The LD₅₀ values of intraperitoneal injection of the M. communis essential oil was 2.23 mL/kg body wt. No significant difference (p > .05) was observed in the clinical chemistry and hematological parameters following oral administrations of M. communis essential oil at the doses 0.05, 0.1, 0.2, and 0.4 mL/kg for 14 days. Conclusion: The results showed potent scolicidal activity of M. communis with no significant toxicity, which might be used as a natural scolicidal agent in hydatid cyst surgery.     

A New Percutaneous Approach for the Treatment of Hydatid Cyst of the Kidney: Long-term Follow-up

Renal hydatid disease is an uncommon benign parasitic infestation compared to liver hydatid disease. Although the treatment of hydatid cysts depends on surgery which is related with high morbidity and an overall local recurrence rates, the following case reports describing two patients with renal hydatid cysts were successfully treated with this new percutaneous method.     

液氮冷冻治疗肺包虫囊肿：附4例报告

报告液氮冷冻治疗肺包虫囊肿４例５次的体会。全组无手术死亡。本组３例术后摘除冰球复温后，伊红染色头节着色率为９５％以上，说明头节死亡，术后无复发的可能性。４例随访４至５年均无复发。并对液氮冷冻治疗的适应证和手术方法等进行了讨论。     

Hydatid Cyst of the Pulmonary Artery Secondary to Hepatic Hydatid Cyst Embolism

A cystic lesion of the liver extending into the inferior vena cava was discovered in a 33-year old female patient suffering from dyspnea, pain and swelling in the legs. Plain chest X-ray was normal. CT and MRI of the thorax showed a cystic lesion within the right pulmonary artery. The liver lesion was treated by a partial cystectomy and omentoplas-ty, inferior vena cava and bile ducts repair. Through a right thoracotomy, a hydatid cyst was found in the pulmonary artery and enucleated. Although very rare, pulmonary artery hydatidosis may be the cause of an unexplained dyspnea in patients with hydatidosis of the liver.     

Study of the Radical vs. Conservative Surgical Treatment of the Hepatic Hydatid Cyst: A 10-Year Experience

The hepatic hydatid cyst is a major health problem in endemic areas. Surgery is still the best choice for the treatment of hydatid cyst of the liver. There is controversy regarding efficacy of radical versus conservative surgical approaches. In this study, we aimed to evaluate the two surgical methods in patients treated for the hepatic hydatid cyst. This is a retrospective review of the medical records of 135 patients who underwent surgery for the hepatic hydatid cyst from 1993 to 2003. Surgery comprised conservative methods (evacuation of the cyst content and excision of the inner cyst layers) and radical methods (total excision of the cyst and removal of its outer layer). One hundred thirty five patients underwent liver surgery. Conservative surgery was performed for 71 (53%), whereas, the remaining 64 patients (47%) underwent radical surgery. Local recurrence rate of the cysts was lower in the radical versus conservative surgery group and the mean length of hospital stay was shorter in the radical surgery group. Radical surgery of the hepatic hydatid cyst may be the preferred treatment because of its low rate of local recurrence, as well as short hospital stay.     

Parenchyma-Preserving Surgery in the Management of Pulmonary Hydatid Cysts

Pulmonary hydatid cysts remain a significant health problem in endemic regions like Turkey. Here, we present our surgical experience in patients with pulmonary hydatid cysts. Between January 1985 and January 2001, 1118 operations were performed in 1032 patients (528 males, 504 females; mean age 32.7 years; range 1–87 years) with pulmonary hydatid cysts in our department. Posterolateral thoracotomy was performed in 1015 (98.3%), two-stage thoracotomy in 34 (3.3%), and median sternotomy in 17 (1.7%) patients. We preferred conservative surgical procedures. As a surgical procedure, cystotomy and capitonnage was performed in 626 (56%), cystotomy alone in 368 (33%), wedge resection in 81 (7%), enucleation in 29 (3%), and decortication in 11 (1%) patients. None of our patients were treated with anatomic resection. During surgery, 949 patients (92%) had unruptured and 83 patients (8%) had ruptured hydatid cyst. The morbidity ratio was 6.7%. Major complications were wound infection (2.3%), prolonged air leak (1.9%), atelectasis (1.2%), pleural effusion (0.8%), postoperative hemothorax (0.6%), and empyema (0.3%). Two patients (0.2%) died within the first month postoperatively. Mean follow-up was 31.2 months. Recurrence was detected in only 35 patients (3.3%). Treatment of pulmonary hydatid cyst is primarily surgical. Medical treatment is indicated for recurrent and multiple hydatid cysts postoperatively. Cystotomy alone, or cystotomy and capitonnage, as parenchyma-preserving surgery, is preferred. Radical surgery including pneumonectomy, lobectomy, and segmentectomy should be avoided.     

Hydatid cyst of the seminal vesicle

We present a rare case of a hydatid cyst involving the seminal vesicle of a 48-year-old man. Urinary retention was the initial symptom. Both imaging and clinical evaluation revealed a substantial retrovesical cystic mass. The histopathological report was 'hydatid cyst of the seminal vesicle'.