Genitourinary Hydatid Disease

Abstract

Genitourinary echinococcosis is an uncommon cyclo-zoonotic disease. It is caused by Echinococcus species. Kidneys are the common target organs in the genitourinary tract. Clinical presentation is usually non-specific. Pre-operative diagnosis requires a high index of suspicion. It should be considered in differential diagnosis of cystic mass of genitourinary tract, especially in endemic regions. Computed tomography, ultrasonography, and antibody testing aid in diagnosing and classifying the stage of the cyst. Although a number of operative techniques have been described, complete removal of germinal layer with daughter cysts without spillage of viable cyst contents with perioperative medical therapy provides an optimum chance of cure with minimal morbidity. Considering the benign nature of the disease, organ preservation is feasible in majority of the cases. The conventional open surgical treatment has evolved into minimally invasive laparoscopic, endoscopic, and even robotic techniques with concomitant improvement in postoperative and cosmetic outcome. Given the rarity of the disease, no randomized control trial comparing the treatment modalities for genitourinary hydatid exists. Moreover, long-term follow up in many cases is unavailable. Overall, the incidence of local and systemic recurrence is low.

Unusual Presentations of Adrenal Masses

“…Adrenal involvement is usually secondary, and part of generalized echinococcosis [25,28]. Most cases are discovered incidentally, although some cases present with nonspecific dull aching flank pain [29]. Adrenal hydatids can cause hypertension, known as "the Goldblatt phenomenon", due to irritation of functional tissue of the adrenal gland by the growing cyst [30].…”

“…niques [29]. It is difficult to determine whether complete excision of adrenal is mandatory as data is limited.…”

Genitourinary Hydatid Disease: A Review

“…Retrovesical echinococcosis accounts for only 0.1-0.5% and 1-2% in a Tunisian series [12,[23][24][25][26]. Most retrovesical HC have been reported from Turkey [6]. Approximately 80% of PE involves the genital area.…”

“…[7] Hydatid cysts (HC) in the peritoneal cavity or pelvis are usually a result of spontaneous rupture from a primary liver focus or following surgical inoculation [10,20]. Pelvic and retrovesical locations are considered primary if no other site is affected [6,10,12,21]. Mostly pelvic HC coexist with hepatic HC, detected before or on simultaneously, hence most of these cysts are secondary [10,12,22].…”

“…We would like to end by saying that very few countries are considered to be completely free of E. granulosus, by virtue of change in occupational practices, nomadic migration of shepherds and their herds and various other incidental factors endemicity of the disease varies, there always will be emergence and re-emergence of the disease in certain countries with its ability to spread Echinococcosis is an infection caused by the larval stage of a cestode (tapeworm) called Echinococcus [4,5]. There are 3 speciesEchinococcus granulosus is the most common type world over, followed by E. multilocularis, E. oligartus and E. vogeli, the latter being popularly known as human polycystic hydatid disease [4][5][6][7].…”