Abstract
Hydatid cyst disease caused by E. granulosus is a zoonotic disease that may involve many body tissues and organs, mainly liver. Adrenal glands are rarely involved even in regions where hydatid cyst disease is endemic. A limited number of studies have been reported on adrenal gland involvement by hydatid cyst disease. Herein, we aimed to report a recurrent case of adrenal hydatid cyst that was misdiagnosed as a hepatic hydatid cyst. A 16-year-old boy with a history of partial cyst excision and evacuation for perforated adrenal hydatid cyst disease three years ago presented to our outpatient clinic with nonspecific abdominal pain. Ultrasonography and computed tomography showed a lesion with an approximate size of 70 × 70 mm compatible with a hydatid cyst, which originated from the segment 5-6 of the liver and extended to the posterior-inferior direction. A surgical intervention was scheduled after a 2-week prophylactic albendazole treatment. During laparotomy using the old incision, it was noted that the cystic lesion that reportedly located in liver was actually a recurrent right adrenal cyst. As dense adhesions existed, the cystic lesion was excised en bloc with the right adrenal gland. As the lesion was totally removed without getting ruptured, albendazole was not administered at the postoperative period. No recurrence was observed at one-year follow-up.
Highlights
Despite four di erent parasites belonging to the echinococcal species having been discovered to cause echinococcal disease in humans, E. granulosus is responsible for approximately 95% of all echinococcal cases
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]
Cystic lesions of the adrenal glands are extremely rare, with the majority being incidentally discovered at autopsy series or detected by radiological studies. erefore, their actual incidence is unknown some series have provided incidence values of 0.06–0.18% [6]. e most common nonneoplastic adrenal cysts are endothelial cysts, pseudocysts, epithelial cysts, and parasitic cysts (6-7%) [4, 6,7,8]
Summary
Despite four di erent parasites belonging to the echinococcal species having been discovered to cause echinococcal disease in humans, E. granulosus is responsible for approximately 95% of all echinococcal cases. Hydatid cyst disease is treated with one or several of the treatment options including medical treatment, surgical treatment (open or laparoscopic), percutaneous treatment by di erent techniques such as the puncture-aspiration-injection-reaspiration (PAIR) method, standard catheterization technique or modi ed catheterization technique (MoCaT), and watch and wait method [2, 5]. It is still unclear which surgical treatment option is better among several options including partial cystectomy or en bloc resection together with the adrenal gland. We aimed to report our clinical management approach to a recurrent case of AHC that was previously misdiagnosed as a hepatic hydatid cyst by radiological studies
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