Laparoscopic management of a large primary retroperitoneal hydatid cyst

Abstract

Hydatid cysts usually involve the liver and lungs, but any other organ can potentially be involved and these can mimic numerous pathologies; however, primary involvement of the retroperitoneum and presentation as a left-sided abdominal mass is quite unusual. A 30-year-old male presented with a large cystic lump in the left side of the abdomen that was diagnosed as a primary retroperitoneal hydatid cyst by a computed tomography scan and serology. The patient was managed successfully by minimal access surgery. This report highlights that a primary retroperitoneal hydatid cyst is a rare clinical entity and should be considered as one of the differential diagnoses in patients presenting with a cystic mass in the retroperitoneum. In the present era of minimal access surgery, it can be safely managed with a laparoscopic approach.

Clinical Characteristics and Management of the Hydatid Cyst of the Liver: A Study from a Tertiary Care Center in Nepal

“…The choice of treatment is based on the types and size of the cysts, available expertise and equipment, and patients' adherence to long-term follow-up [ 27 ]. Many authors recommend surgery as the definitive modality of management, as it is the best option to remove the cysts and results in a complete cure [ 6 , 7 , 11 ]. In our study, 43.4% of the patients underwent surgery for definitive removal of hydatid cysts.…”

“…Options for the treatment of HCL include surgery, percutaneous approaches, medications, and observation. Surgical removal of the cyst has remained the traditional and the gold standard for definitive management of HCL [ 11 ]. However, the alternative modalities of treatment like cyst puncture, aspiration, injection of chemicals, and reaspiration (PAIR) have progressively supplemented and in some cases even replaced surgery as the treatment of choice [ 6 , 12 ].…”

A 14 Years Hospital Based Study on Clinical and Morphological Spectrum of Hydatid Disease

“…At present the defi nitive treatment for hydatid cyst is surgical removal of the cyst which remains the gold standard. 3,28,29 Besides surgery, non conventional treatment like PAIR (Puncture, Aspiration, Injection, Reaspiration) had been widely studied recently and was found safe and effective. 30 In medical treatment imidazole group of drugs (mebendazole and albendazole) are widely used but are contraindicated in pregnancy, hepatic and renal impairment.…”

Laparoscopic treatment of retroperitoneal cystic mesothelioma. Two cases reported

“…Malignant PRCL such as mucinous cystadenoma and cystadenocarcinoma, pseudomyxoma retroperitonei and solid neoplasms with cystic transformation (leiomyosarcoma, paraganglioma), are rare [5], [7], [8], [9], [10]. On the contrary, a wide variety of benign retroperitoneal cystic lesions has been described [5], [8], [9], [10], [11], [12], [13], [14], [15], such as müllerian cyst, hydatid cyst, lymphangioma, cystic mesothelioma, cystic teratoma, tailgut cyst, epidermoid cyst, post-traumatic pseudocyst, lymphocele following abdominal surgery, urinoma, hematoma and bronchogenic subdiaphragmatic cyst.…”