Diagnosis Of Hydatid Cyst Research Articles

Clinical Characteristics and Management of the Hydatid Cyst of the Liver: A Study from a Tertiary Care Center in Nepal.

A hydatid cyst of the liver is a significant yet neglected public health problem in Nepal. The present study was carried out to evaluate the demographic characteristics, clinical presentations, and management of the patients of the hydatid cyst of the liver in the setting of a developing country. It was a retrospective, descriptive analysis of 53 patients admitted in the department of surgery with the diagnosis of hydatid cyst of the liver based on clinical manifestations, imaging studies, or serology between 2016 and 2019. The median age of the patients was 36 years, with the age group of 25-45 years being the most commonly affected (23, 43.4%). 58.5% of the patients were female. Abdominal pain (49, 92.5%) and a palpable liver (17, 32.1%) were the most common complaint and physical finding in our study population, respectively. Abdominal ultrasonography and computed tomography scan were the major imaging studies used to establish a diagnosis. A unilocular and anechoic cystic lesion was the most frequent imaging finding. The right lobe of the liver harbored the cysts in the maximum number of patients. Surgery was the preferred modality of treatment (23, 43.4%), with pericystectomy being the most common form of surgical intervention. The hydatid cyst of the liver is a common cause of morbidity in Nepal. Clinical evaluation supplemented by imaging studies is required for diagnosis, and surgery remains the treatment of choice in most cases. To explain the epidemiological pattern of the disease, multicentric studies involving a larger sample of patients should be conducted.

Clinical and Laboratory Presentation of Hydatid Disease: A Study From Northeast India.

IntroductionHydatid disease is an immense health problem in developing countries. The diagnosis of hydatid cyst is often difficult because of its protean manifestations. Our objective was to evaluate the various clinical and laboratory presentations of hydatid disease and various modalities of treatment from a tertiary care center.Materials and methodsWe reviewed the clinical and laboratory features of patients presenting with hydatid cyst through retrospective analysis from January 2018 to December 2019 from a tertiary care hospital in northeast India.ResultsOf the 26 adult patients with hydatid cysts who were part of the study, 14 (53.8%) were males and 12 (46.2%) were females. The mean age was 34.6 years. The most common site of involvement was the liver (69%) followed by lung (19.2%) and brain (7.7%). Palpable mass in the right upper quadrant of the abdomen was the most common symptom (88.3%) for liver hydatid cyst followed by pain abdomen (66.6%). Systemic symptoms like fever and weakness were present in most of the patients. The majority of patients (80%) were from rural areas.ConclusionHydatid cysts present with varied symptomatology. History of exposure to infected animals may not be present. A high degree of clinical suspicion combined with meticulous history and clinical examination supported by laboratory investigations are required for its diagnosis.

An Iranian man with increased thigh mass due to a hydatid cyst.

Background: Hydatid cyst is a zoonotic infection caused by Echinococcosis granulosus. Primary single-intramuscular hydatid disease is rare, even in endemic regions of the world. Here we report the case of exceptional thigh mass due to a hydatid cyst in an Iranian man.Case presentation: An 86-year-old man, initially presented to Velayat teaching hospital surgery clinic in May 2017 with a single right-thigh mass, but physical examinations of other organs were unremarkable. Based on sonographic findings, the differential diagnosis was hydatid cyst. He underwent surgical resection of the cyst. Histopathological results confirmed the diagnosis. There was no evidence of recurrence of the lesion during the 23-month follow-up. Conclusion: Increase thigh mass due to a hydatid cyst is a rare event. In endemic regions with the presence of hydatid cysts, especially physicians of surgical clinics have to consider differential diagnosis of hydatid cysts in unusual locations in case of such a lesion.

Retrospective evaluation of postsurgical outcomes of patients operated with the diagnosis of pulmonary hydatid cyst

Objective: Hydatid cysts may occur in almost every organ and tissue of human the body. Because they can be found in more than one organ/tissue, sometimes many operations may need for them and surgical intervention may be required due to complications that may develop secondary to hydatid cyst surgery albeit few. Method: Data on patient files retrieved from the hospital information management system or archive were analyzed retrospectively. Surgical results of patients operated with the diagnosis of hydatid cyst between 2008 and 2018 in our clinic were discussed retrospectively. Results: Ninety-three operations were performed in 84 patients due to pulmonary hydatid cysts. Fourty-four of them were male (52.4%), 40 were female and their mean age was 44 (5-85) years. Twenty-two (26.2%) patients were asymptomatic and 62 (73.8%) were symptomatic. Hydatid cysts were located in right hemithorax in 45 (53.6%) patients, in left hemithorax in 30 (35.7%) patients and bilaterally in 9 (10.7%) patients. Twenty-six patients (31%) had both pulmonary and hepatic hydatid cysts. Posterolateral thoracotomy and cystotomy-capitonnage were the most common methods (89.3%), 9 patients (10.7%) underwent wedge resection. Four patients developed atelectasis, 2 patients had hydropneumothorax, 4 patients had isolated prolonged air leak, 1 patient developed massive pulmonary embolism, and 1 patient developed Aspergillus infection the quilted cavity. Conclusions: Hydatid cyst disease has still been a serious health concern in Turkey. When the careful and experienced surgeons perform the operations, the postoperative period is usually uneventful and morbidity is extremely low.

A rare location of primary extrahepatic hydatid cyst in the soft tissue

Hydatid cyst or cystic echinococcosis in human is rare disease caused by tapeworm Echinococcus granulosa. Hydatid cyst of soft tissue is a rare condition and we had a case of large hydatid cyst in lumbar region. This is a case of 48 years old female presented to us during October 2018 with a large diffuse swelling over the left lumbar region which was gradually grown over the last 2 years without pain. The diagnosis of hydatid cyst was not sure even in CT scan but it was in our differential diagnosis. It is confirmed during surgery after seen the multiple cyst removed from the large cystic lesion. No recurrence even after 15 months of follow up. Presence of hydatid cyst in soft tissue is usually rare and its diagnosis is not expected clinically when it presents as a soft tissue swelling. We need to confirm it during surgery or by presence of typical germinal membrane under microscope.

Hydatid cyst of the lung in pregnancy: A rare case presentation

Hydatid cyst of the lung has been seen in 30% of the cases of hydatidosis in some series. In our case presentation, a 29-year old female, gravida 1, referred to the hospital with acute and severe pain in the lower left hemithorax, while she was in the 26th week of pregnancy. The pain was pleuritic and was accompanied with tachypnea. The patient was hospitalized with suspected pulmonary embolism. The chest X-ray and computed tomography showed a cystic mass in the lower left lung. After a diagnosis of hydatid cyst, the patient underwent surgery and all of her symptoms were resolved. As Albendazole is a medication from pregnancy category C, and since in our case, the patient underwent surgery and all of her symptoms were resolved, we can conclude that surgery is a safe and appropriate treatment for Hydatid cyst of the lung in pregnancy.

Nossa experiência clínica e resultados no acompanhamento de casos de cisto hidático

Background and objectivesHydatid cyst is a zoonotic disease caused by Echinococcus granulosus. The aim of our study is to present the clinical features of the patients who were treated for hydatid cyst, determine the interventional techniques and anesthesia methods used and review the occurred complications in detail. MethodsThis study included 393 patients who were followed up and/or treated with the diagnosis of hydatid cyst between January 2013 and November 2018. The patients’ data was evaluated retrospectively. ResultsThe mean age of the patients was 31.0±17.2 years. Of the patients, 111 (28.4%) had more than one cyst and 36 (9.2%) patients had multi‐organ involvement. Six of the patients refused the intervention or was transferred to another hospital. Among the remaining 387 patients, 335 (85.2%) received general anesthesia and intubation, 9 patients (2.3%) received general anesthesia and laryngeal mask airway, 39 patients (9.9%) received sedoanalgesia and 4 patients (1%) received regional anesthesia. Perioperative mortality was developed in one patient. The most common periopertaive complication was allergic reaction (1.5%), whereas the most common post‐operative complications were atelectasis (3.3%) and biliary fistula (3%). The mean Intensive Care Unit stay (ICU) was 1.9±1.1 days in patients requiring ICU. Recurrence during the 40±17 months follow‐up occurred in 8.4% patients. ConclusionsAnesthesiologists have an important role in the management of hydatid cyst patients. Patients should be evaluated exhaustively in terms of multi‐organ involvement and the presence of more than one cyst in the same organ. The type of treatment procedure and the localization of the cysts determine the anesthetic management.

Our clinical experience and follow-up results in hydatid cyst cases: a review of 393 patients from a single center

Background and objectivesHydatid cyst is a zoonotic disease caused by Echinococcus granulosus. The aim of our study is to present the clinical features of the patients who were treated for hydatid cyst, determine the interventional techniques and anesthesia methods used and review the occurred complications in detail. MethodsThis study included 393 patients who were followed up and/or treated with the diagnosis of hydatid cyst between January 2013 and November 2018. The patients’ data was evaluated retrospectively. ResultsThe mean age of the patients was 31.0±17.2 years. Of the patients, 111 (28.4%) had more than one cyst and 36 (9.2%) patients had multi-organ involvement. Six of the patients refused the intervention or was transferred to another hospital. Among the remaining 387 patients, 335 (85.2%) received general anesthesia and intubation, 9 patients (2.3%) received general anesthesia and laryngeal mask airway, 39 patients (9.9%) received sedoanalgesia and 4 patients (1%) received regional anesthesia. Perioperative mortality was developed in one patient. The most common periopertaive complication was allergic reaction (1.5%), whereas the most common post-operative complications were atelectasis (3.3%) and biliary fistula (3%). The mean Intensive Care Unit stay (ICU) was 1.9±1.1 days in patients requiring ICU. Recurrence during the 40±17 months follow-up occurred in 8.4% patients. ConclusionsAnesthesiologists have an important role in the management of hydatid cyst patients. Patients should be evaluated exhaustively in terms of multi-organ involvement and the presence of more than one cyst in the same organ. The type of treatment procedure and the localization of the cysts determine the anesthetic management.

Pearls in the appendix (Myxoglobulosis) : a case report

We report a rare variant of mucocele of the appendix. An elderly gentleman was admitted with symptoms and signs of acute appendicitis. He underwent laparoscopic converted open appendicectomy. On exploration there were pearls or fish egg like globular material along with jelly in and around the appendix. On examination of the specimen a differential diagnosis of hydatid cyst or pseudomyxoma was considered. On microscopic examination, the globules consisted of eosinophilic laminations of mucin surrounding an amorphous granular core. After histopathological examination, our case was diagnosed as myxoglobulosis of the appendix.Acute appendicitis is a common clinical problem and appendisectomy a regular surgery. The clinician should be aware of this entity of myxoglobulosis, to avoid confusion with pseudomyxoma or hydatid cyst. Presence of typical fish eggs or pearls like globular structures in and around the appendix is suggestive of myxoglobulosis. Appendisectomy is curative treatment for patients with myxoglobulosis of appendix and there are no reports of its recurrence.

Hydatid cyst of the foot: a case report

BackgroundHydatid cyst is rarely located in soft tissues. This case of a hydatid cyst over the plantar surface of our patient’s foot is one of the rarest presentations.Case presentationThis is a case report of a 22-year-old Somali who presented with a lump over the plantar surface of his foot of 1-year duration. The diagnosis of hydatid cyst was made intraoperatively from the typical appearance of a hydatid cyst. The cyst was completely excised. No local recurrence has been detected to date.ConclusionsThe rare location and uncommon incidence made the initial diagnosis of hydatid cyst of the foot difficult. Detection of the typical germinal membrane can guide the diagnosis of hydatid cyst in rare locations that are found incidentally.

Hepatic adenoma mimicking liver hydatid disease: Case report

Case Report: A 34-year-old female obese patient, married, who lived in Abreu e Lima (PE), with a history of moderate abdominal pain in the right flank and weight loss (10 kg in 7 months): She visited Para State two years ago and denied having used any oral hormonal contraceptive. Imaging exams showed big cystic and multiloculated formations in the liver, with the largest being of 16 x 13 x 14cm. Due to the aspects of the image, epidemiology and the symptoms of the patient, a diagnosis of hydatid cyst was considered, and the patient was treated with praziquantel and albendazole. The surgical procedure was proposed based on the recommendations of the WHO for the treatment of hydatic disease, even without the result of the serology test. Operatory findings showed cystic lesions with a pasty and amorphous content, of yellow-green aspect. The surgical specimen evaluation showed a hepatic adenoma with necrotic tissue and central cavitation. The diagnosis was confirmed by immunohistochemistry. The serology test for echinococcosis was negative. The patient had no further complications and was discharged in good clinical condition. Conclusion: We presented rich iconographic information of all aspects of this case and reviewed all the differential diagnoses for cystic lesions of the liver.

Co-existence of renal hydatid cyst and renal cell carcinoma in one kidney: A case report

Rationale: Cystic echinococcosis (hydatid disease) is a parasitic infection of humans, but renal hydatid cyst is rare. It is even more uncommon to find hydatid cyst and renal cell carcinoma (RCC) synchronously in one kidney. Patient concerns: This report presents a 47 years old Iranian man with the chief complaint of lower abdominal pain. Abdominal ultrasound and computed tomographic scan was performed for more evaluation. Diagnosis: RCC was the most probable diagnosis, so he went under left total nephrectomy. Eventually, after histopathologic examination of the excised kidney, cystic echinococcosis came to the first line and papillary RCC was the second diagnosis. Outcomes and lessons: Diagnosis of hydatid cyst and RCC is mostly based on imaging, but, as we noticed in this case, distinguishing between these two may sometimes be difficult due to radiological similarities.

Mucinous Cystadenoma of Liver with Mesenchymal Stroma

Hepatobiliary cystadenoma is a rare benign cystic tumor of the liver. These are predominantly located in right hepatic lobe. A 45 year old female presented with abdominal pain, epigastric discomfort, fever and vomiting. On radiological evaluation USG showed large multiloculated cystic mass in right lobe of liver. Contrast Enhanced CT examination exhibited exophytically growing multiloculated cytic lesion with differential content and peripheral capsular and central enhancement with imaging diagnosis of hydatid cyst was given. The surgical excision of hepatic cyst was done. On histopathology reported as mucinous cystadenoma of liver with mesenchymal stroma. We are presenting this case for its rarity, clinical, radiological and histopathological findings.

Hydatid cyst disease in children: 10-years experience at two tertiary centers from Northeast Anatolia of Turkey

Aim: Hydatid cyst remains a significant health problem in endemic regions such as Turkey. It can be observed at any age, but the diagnosis is usually made at adulthood. The aim of this study was to investigate the epidemiological findings of hydatid cyst cases in the pediatric age group in Turkey. Material and Methods: The records of the patients who received the diagnosis of hydatid cyst in the pathology departments of Ataturk University Faculty of Medicine and Erzurum Regional Training and Research Hospital between 2009–2019 were analyzed retrospectively. Data such as age, sex, location, size and number of cysts of the cases diagnosed with hydatid cyst between 0–16 years of age were analyzed statisticall.Results: Of the 1072 cases diagnosed with hydatid cyst, 32.7% (n=351) were within the age range of 0–16 years, 57.8% (n=203) were male and 42.2% (n=148) were female, with a mean age of 10.8 years (SD: ± 3.5; min: 1, max: 16). In 86.3% (n=303) of the cases, the cyst was found to be located in a single organ, whereas it was located in two different organs in 13.7% (n=48) of the cases. Involvement of the liver and lung was observed in 54.4% (n=191) and 50.4% (n=177) of the cases, respectively. Less involvement was observed in brain (n=10), kidney (n=9), spleen (n=5), retroperitoneal region (n=4), omentum (n=2), nasal cavity (n=1), thoracolumbar region (n=1), tail of the pancreas (n=1) and ulna diaphysis (n=1). In all cases, the mean cyst size was measured to be 7.4 cm (SD: ± 2.9; min: 1.5, max: 17) based on the largest cyst size.Conclusion: Hydatid cyst is also common in the pediatric age group. Hydatid cyst has been found to be more common in males in the pediatric age group in Turkey, with its most common localization being in the liver and lung.

Extradural Hydatid Cyst of the Lumbo-Sacral Spine

Primary spinal hydatid cyst is a rare and uncommon entity but a significant manifestation of hydatid disease. Here, we report a case of primary extramural hydatid cyst of the sacral region causing cord compression. Pre-operative differential diagnosis was that of Tarlov cyst owing to the radiological appearance and location of the cyst. The diagnosis of hydatid cyst was established intra-operatively which was later confirmed by histopathology report. Hydatidcyst may not fall under differential diagnosis of extramural lesions of the spine due to its rarity but should be kept under high suspicion in endemic countries.

Primary Pancreatic Echinococcosis: A Rare Cause of Pancreatic Cyst

Introduction: Primary Hydatid cyst of pancreas is a rare entity even in endemic countries. These cases usually present with non specific symptoms such as pain abdomen, vomiting or feeling of vague lump in abdomen.
 Presentation of Case: A 55 year old lady presented to GI surgery department, GB Pant institute of Postgraduate Medical Education and Research (GIPMER), India with complaints of lump in abdomen and pain abdomen which was evaluated with imaging studies (Computed tomography scan Abdomen and Magnetic resonance imaging Abdomen). Initially considered as cystic lesion pancreas, Endoscopic ultrasound (EUS) confirmed diagnosis of Hydatid cyst and patient underwent open deroofing and drainage of cyst with uneventful post operative period.

Bartonellosis a Rare Cause of a Splenic Cyst

Background: Bartonellosis comprises infections caused by the emerging pathogens in the genus Bartonella. B henselae is the cause of cat scratch disease. Most of the cases present with the typical self-limited regional lymphadenitis. Isolated splenic involvement is very rare. Here we present a case of splenic cyst which was found to be due to Bartonella Henselae. The case: A 30 years old, previously healthy female presented with non-specific poorly localized abdominal pain for 2 months. Her condition was not associated with any gastrointestinal symptoms or fever. She had close contact with pets (dogs and cats). Physical examination was only positive for a palpable spleen of about 6 cm below the costal margin. Abdominal U/S and CT showed a loculated splenic cyst in the lower pole with wall calcification. Blood tests were unremarkable. A provisional diagnosis of Hydatid cyst was made and the patient received albendazole tabs and planned for splenectomy. Splenectomy was done and histopathological examination of the spleen revealed collection of black small filaments that stain positive for Bartonella Henselae, associated with marked vascularity. Patient run an uneventful postoperative course and was prescribed oral erythromycin for 3 weeks. Conclusion: Bartonellosis is rare in immunocompetent patients and isolated splenic involvement is even extremely rare. The case presented here represents this atypical presentation of this rare disease.

Evaluation of clinical, diagnostic and treatment aspects in hydatid disease: analysis of an 8-year experience.

Echinococcosis is still a common health problem. The aim of this study was to discuss our 8-year data in terms of diagnosis, treatment and follow-up of cystic Echinococcosis. A total of 178 patients who had hydatid cyst were analyzed retrospectively from the hospital records. The diagnosis of hydatid cyst was based on clinical-serological and radiological findings. Treatment response was evaluated with clinical, radiological and serological findings. A total of 178 medical records were evaluated; the male:female ratio was 0.73 and mean age 44.6±16.9 years. The most common symptom was abdominal pain (94, 52.8%). The mean cyst size was 9.5±3.9 cm. Eosinophilia was significantly higher in patients with complicated cyst (35.3%) (p=0.002). The average duration of hospitalization in surgical patients was shorter than non-surgical patients (p=0.026). There was no significant correlation between the preference of scolicidal agent (hypertonic saline, H2O2, povidone iodine) and recurrence in patients who underwent surgery (p>0.05). There was no significant difference between the patients who underwent radical and conservative surgery in terms of complication and recurrence (p=0.077, p=0.557). No significant difference was found between percutaneous and surgical treatment in terms of complication and recurrence (p=0.264, p=0.276). Even though considerable progress has been made, uncertainties remain in the diagnosis and treatment of Echinococcosis. Hence, standardized diagnostic and treatment procedures should be established with well-designed studies.

A Cyst Close to the Heart

A 49-year-old Lebanese man presented to the hospital with right-sided pleuritic chest pain without associated respiratory or systemic symptoms. His vitals on presentation were stable, and examination was unremarkable. He had mild leukocytosis with 9.8% eosinophils. Imaging including cardiac magnetic resonance imaging with and without contrast revealed an extra pericardial, multiloculated anterior mediastinal cyst (Figure 1). A diagnosis of hydatid cyst was suspected based on epidemiologic history and radiologic appearance. Echinococcus serology was found to be positive. Patient was started on empiric anthelminthic treatment followed by surgical excision. Intraoperatively, the wall of the excised cyst showed calcification and sebaceous contents (Figure 2). Histopathologic exam showed multilocular cyst lined by squamous epithelial cells and foci of mature bone tissue (Figure 3), pancreatic acini, and ciliated columnar epithelial ducts consistent with a diagnosis of benign mature cystic teratoma. No parasite was seen. Anthelminthic therapy was discontinued, and the patient reported to be doing well on the follow-up visit. Similar cases have been reported in the past.1Patel I.J. Hsiao E. Ahmad A.H. Schroeder C. Gilkeson R.C. AIRP Best Cases in radiologic-pathologic correlation: mediastinal mature cystic teratoma.RadioGraphics. 2013; 33: 797-801Crossref PubMed Scopus (19) Google Scholar, 2Jaakik B. Benjelloun H. A Rare pericardial cyst resembling hydatid cyst on echocardiography.Intern Med. 2010; 49: 1673-1674Google Scholar, 3Montebello A. Mizzi A. Cassar P.J. Cassar K. Benign cystic mediastinal teratoma presenting as a massive pleural effusion in a 17-year–old boy.BMJ Case Reports. 2017; 2017 (bcr2016217439)Google ScholarFigure 2View Large Image Figure ViewerDownload Hi-res image Download (PPT)Figure 3View Large Image Figure ViewerDownload Hi-res image Download (PPT) The authors wish to acknowledge Dr Khushi Nagori, MBBS, Department of Pathology, Ascension St John Hospital, Detroit, Michigan.

Hydatid cyst of parotid gland mimicking as Branchial cyst in a 7 year child: A cytological impression

Hydatid disease also known as Echinococcosis is a parasitic infection caused by the cestodes of Echinococcus granulosus. Hydatid cyst of the head and neck region is uncommon and the involvement of parotid gland is very rare and few cases have been reported in literature. We report a rare case of hydatid cyst in a 7year old female child who presented to the otorhinolaryngology outpatient with gradually progressive swelling on left parotid region for 3 years. The probable clinical and radiological differentials were 1st branchial cleft cyst, lymphangioma and retention cyst. However aspiration cytology revealed multiple scolices, hooklets, and granular necrotic debris which confirmed the diagnosis of hydatid cyst. CT scan of the abdomen and thorax did not reveal any other organ involvement by the disease process. Chemotherapy with albendazole was started and surgery was performed after 1 month. This case is reported here owing to its rare and unusual presentation.