Abstract
IntroductionIn North Africa which is an endemic region for Hydatid Cyst, Tunisia is considered as an endemic country. The liver and lungs are common locations for Hydatid Cysts, whereas the Adrenal Glands are unusual and rare locations. Presentation of caseHere is a report of primary Hydatid Cyst in a 55-year old patient, with left hypochondrium pain as chief complain. No remarkable findings were revealed by physical examination and blood analysis showed normal range. Hydatid serology was negative. The diagnosis of Hydatid Cyst was suspected based on CT Scan results which showed a well-circumscribed, non-enhanced, multi-cystic, 12 cm mass with scattered calcifications located in the left adrenal gland. Therefore, the patient underwent an open surgery with resection of the protruding dome of the cyst as it was attached to the renal pedicle, the pancreatic tail, the spleen and the jejunum. The final pathological examination of the specimen led to a Hydatid Cyst. DiscussionThroughout an extensive literature review that we have made, we have analyzed 54 reported cases, with their clinical presentations, biological exams, radiological features and surgical managements. The treatment should be surgical and has to be as conservative as possible. The prevention of the parasite transmission has to be the cornerstone of the disease management. ConclusionThe hydatid cyst of the adrenal gland remains a rare diagnosis that has to be evoked in case of an adrenal gland cyst, especially in an endemic country.
Highlights
In North Africa which is an endemic region for Hydatid Cyst, Tunisia is considered as an endemic country
After passing through the digestive system, the larvae are released; they pass through hepatic filter to the lungs. If they are not destroyed by the immune system or trapped in the filtration system; they can spread anywhere in the body, giving unusual locations of the hydatid cyst as spleen, kidneys, brain, bones, heart, muscle tissue, pancreas, retroperitoneum, thyroid and adrenal glands, through the arterial circulation
Based on a systematic Pubmed search using the keywords ‘Adrenal Gland’ and ‘Hydatid Cyst’, we have found 76 cases published in the literature
Summary
In North Africa which is an endemic region for Hydatid Cyst, Tunisia is considered as an endemic country. The liver and lungs are common locations for Hydatid Cysts, whereas the Adrenal Glands are unusual and rare locations. PRESENTATION OF CASE: Here is a report of primary Hydatid Cyst in a 55-year old patient, with left hypochondrium pain as chief complain. The diagnosis of Hydatid Cyst was suspected based on CT Scan results which showed a well-circumscribed, non-enhanced, multicystic, 12 cm mass with scattered calcifications located in the left adrenal gland. DISCUSSION: Throughout an extensive literature review that we have made, we have analyzed 54 reported cases, with their clinical presentations, biological exams, radiological features and surgical managements. CONCLUSION: The hydatid cyst of the adrenal gland remains a rare diagnosis that has to be evoked in case of an adrenal gland cyst, especially in an endemic country
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