Isolated renal hydatid cyst misdiagnosed and treated as a cystic renal tumor: a diagnostic pitfall
Abstract 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 pathognom...
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doaj-fc7aba20365a410896477e8e299ee18d2021-06-06T11:23:01ZengSpringerOpenAfrican Journal of Urology1110-57041961-99872021-05-012711410.1186/s12301-021-00176-4Isolated renal hydatid cyst misdiagnosed and treated as a cystic renal tumor: a diagnostic pitfallMoez Hamdani0Ahlem Bdioui1Oussama Belkacem2Nizar Jelidi3Atika Baccouche4Wiem Majdoub5Sihem Hmissa Belhaj Salah6Department of Pathology, Sahloul University Hospital of SousseDepartment of Pathology, Sahloul University Hospital of SousseDepartment of Pathology, Sahloul University Hospital of SousseDepartment of Pathology, Sahloul University Hospital of SousseDepartment of Pathology, Sahloul University Hospital of SousseDepartment of Pathology, Sahloul University Hospital of SousseDepartment of Pathology, Sahloul University Hospital of SousseAbstract 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.https://doi.org/10.1186/s12301-021-00176-4Hydatid cystEchinococcus granulosus infectionNephrectomyMisdiagnosisCase report |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Moez Hamdani Ahlem Bdioui Oussama Belkacem Nizar Jelidi Atika Baccouche Wiem Majdoub Sihem Hmissa Belhaj Salah |
spellingShingle |
Moez Hamdani Ahlem Bdioui Oussama Belkacem Nizar Jelidi Atika Baccouche Wiem Majdoub Sihem Hmissa Belhaj Salah Isolated renal hydatid cyst misdiagnosed and treated as a cystic renal tumor: a diagnostic pitfall African Journal of Urology Hydatid cyst Echinococcus granulosus infection Nephrectomy Misdiagnosis Case report |
author_facet |
Moez Hamdani Ahlem Bdioui Oussama Belkacem Nizar Jelidi Atika Baccouche Wiem Majdoub Sihem Hmissa Belhaj Salah |
author_sort |
Moez Hamdani |
title |
Isolated renal hydatid cyst misdiagnosed and treated as a cystic renal tumor: a diagnostic pitfall |
title_short |
Isolated renal hydatid cyst misdiagnosed and treated as a cystic renal tumor: a diagnostic pitfall |
title_full |
Isolated renal hydatid cyst misdiagnosed and treated as a cystic renal tumor: a diagnostic pitfall |
title_fullStr |
Isolated renal hydatid cyst misdiagnosed and treated as a cystic renal tumor: a diagnostic pitfall |
title_full_unstemmed |
Isolated renal hydatid cyst misdiagnosed and treated as a cystic renal tumor: a diagnostic pitfall |
title_sort |
isolated renal hydatid cyst misdiagnosed and treated as a cystic renal tumor: a diagnostic pitfall |
publisher |
SpringerOpen |
series |
African Journal of Urology |
issn |
1110-5704 1961-9987 |
publishDate |
2021-05-01 |
description |
Abstract 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. |
topic |
Hydatid cyst Echinococcus granulosus infection Nephrectomy Misdiagnosis Case report |
url |
https://doi.org/10.1186/s12301-021-00176-4 |
work_keys_str_mv |
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