Uncommon primary hydatid cyst occupying the adrenal gland space, treated with laparoscopic surgical approach in an old patient

Abstract

<jats:title>Abstract</jats:title><jats:p>Hydatid disease (HD) is caused by Echinococcus Granulosus (EG), which is a larva endemic in many undeveloped areas. The most common target is the liver (59%–75%). The retroperitoneal space is considered as a rare localization. We report an uncommon case of HD located in the adrenal gland space.</jats:p><jats:p>Presentation of case. This is a 78-year-old Moroccan woman, with right flank pain for eight months previously. She denied contact with dogs or sheep. Her physical examination was normal. There was no pathological alteration of laboratory exams. CT scan measuring 5 cm without clear signs for a sure diagnosis found a round lesion in the right adrenal gland. An abdominal MRI showed a round mass of 34 x 27 mm with fluid component without a clear plane of dissection from kidney and liver. A laparoscopic procedure was performed to obtain a histological diagnosis. We reached a conclusive diagnosis of Hydatid cyst of right adrenal gland space.</jats:p><jats:p>Hydatid cysts often develop in the liver. The location in the adrenal bed is rare without clinical signs related to alteration of the gland’s secretion. Hydatid cyst identification in the adrenal gland space is based on ultrasonography, CT or MRI scans. The differential diagnosis includes various benign and malignant lesions. Laparoscopic procedure is the best approach available to obtain a histological diagnosis and a curative treatment.</jats:p><jats:p>The best treatment for HD is the pericystectomy. Laparoscopic surgery can guarantee a radical resection of these lesions when it performed by an expert surgeon.</jats:p>

Renal Kist Hidatik Tedavisinde Laparoskopik Transperitoneal Yaklaşımın Etkinlik ve Güvenirliğinin Değerlendirilmesi

“…Asemptomatik dönemdeki başlangıç lezyonlar tamamen kistik görünürken germinal tabakanın oluşması ve lümen içi basınç kaybı ile kapsül fibrotik hale gelebilir ve bazen de ölü parazitlere bağlı kalsifiye görünüm oluşturur. Bu aşamada hidatik matriksten ayrılmış lümende serbestçe yüzen kız veziküller izlenir (11,12). Bizim serimizdeki tüm olgularda görüntüleme (BT/MR) yöntemleri ile komplike kist-hidatik kist ayırıcı tanısı yapılarak renal kist hidatik tanısı doğrulandı.…”

Hydatid Cyst of the Adrenal Gland: Is Radical Surgery Necessary for Recurrent Hydatid Disease?

“…As is the case for other hydatid cysts involving other organs, AHC is usually asymptomatic, usually being detected incidentally in radiological studies performed for other indications [ 4 , 9 , 12 ]. AHCD rarely becomes symptomatic, with most symptoms being related to the interaction of a cyst with adjacent organs and tissues (e.g., compression and inflammation) [ 3 , 4 , 9 , 12 ]. Particularly, inflammation causes signs and symptoms of peritoneal irritation [ 9 ].…”

“…Medical treatment is not needed for cases where the cystic lesion is totally excised. Surgical treatment can be applied by open or laparoscopic approach depending on the surgical expertise of a given center [ 3 , 6 ]. In parallel to technological advances, transperitoneal and retroperitoneal laparoscopic surgery have emerged as good alternatives [ 3 , 4 , 6 ].…”

“…Also known as cystic echinococcus, hydatid cyst disease most commonly involves the liver, lungs, spleen, and kidneys [ 1 , 2 ]. Adrenal glands are one of the most rarely involved organs even in regions where the disease is endemic [ 2 , 3 ]. Most patients with adrenal hydatid cyst disease (AHCD) may remain asymptomatic for years, and the majority of cases are diagnosed incidentally by radiological studies performed for other indications [ 2 , 4 ].…”

Primary hydatid cyst of adrenal gland: Case report

“…Hydatid cysts can affect all organs and tissues [1 , 2] ; however, in the human body, liver (45%-77%) and lungs (10%-50%) are the two most commonly affected organs [3 , 4 , 7 , 9 , 10] . Hydatid cyst disease is rarely seen in the adrenal glands.…”