Abstract
IntroductionA primary hydatid cyst of the adrenal gland is still an exceptional localization. The adrenal gland is an uncommon site even in Morocco, where echinococcal disease is endemic.Case presentationWe report the case of a 64-year-old Moroccan man who presented with the unusual symptom of arterial hypertension associated with left flank pain. Computed tomography showed a cystic mass of his left adrenal gland with daughter cysts filing the lesion (Type III). Despite his negative serology tests, the diagnosis of a hydatid cyst was confirmed on surgical examination. Our patient underwent surgical excision of his left adrenal gland with normalization of blood pressure. No recurrence has occurred after 36 months of follow-up.ConclusionThere are two remarkable characteristics of this case report; the first is the unusual location of the cyst, the second is the association of an adrenal hydatid cyst with arterial hypertension, which has rarely been reported in the literature.
Highlights
A primary hydatid cyst of the adrenal gland is still an exceptional localization
There are two remarkable characteristics of this case report; the first is the unusual location of the cyst, the second is the association of an adrenal hydatid cyst with arterial hypertension, which has rarely been reported in the literature
Any obvious spillage had not been recorded, one month of oral albendazole 800 mg/day was started postoperatively to avoid recurrence because of the large size of the cyst. In endemic countries such as Morocco, primary Hydatid disease (HD) should be considered in the differential diagnosis of an adrenal cyst and no attempt to preoperatively puncture or to perform any other manipulation of the lesion should be done
Summary
Hydatid disease (HD) is caused by Echinococcus granulosus larva and is endemic in many countries, including those in the Middle East, Eastern Europe, Africa, Latin America and China. Case presentation A 64-year-old Moroccan man was admitted to our department for left flank pain with no particular irradiation that had started one month previously and nausea and vomiting of one day’s duration He reported no digestive or urinary symptoms and was afebrile. He had no significant medical history apart from new-onset arterial hypertension one year before (systolic blood pressure, 170 mmHg to 190 mmHg; diastolic blood pressure, 90 mmHg to 100 mmHg) requiring combination therapy with bisoprolol and amlodipine. He denied any contact with dogs or sheep. Ultrasound monitoring did not detect any hydatid recurrence, and our patient was doing well and symptom free
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