Incidental Isolated Pancreatic Hydatid Cyst

Abstract

Isolated pancreatic hydatid cysts are a rare parasitic disease even in endemic areas. It is difficult to discriminate primary pancreatic hydatid cysts from other cystic and solid lesions of the pancreas. This is a case report of an incidental isolated pancreatic hydatid cyst. A heterogeneous cystic lesion in the body of the pancreas was identified on magnetic resonance imaging of a patient previously diagnosed patient with cholelithiasis, and because of the malignant possibility of the lesion, splenectomy with distal pancreatectomy and cholecystectomy was performed. The histopathologic diagnosis was reported as a hydatid cyst. Pancreatic hydatid cysts should be kept in mind in the differential diagnosis of pancreatic pseudocysts and cystic malignancies. (Turkiye Parazitol Derg 2015; 39: 75-7) Keywords: Hydatid cyst, incidental, pancreas Received: 19 Temmuz 2013Accepted: 4 Eylül 2014 ÖZETİzole pankreas kist hidatiği endemik bölgelerde bile çok nadir görülen paraziter hastalıktır. Sadece pankreasta yerleşen primer kist hidatiklerin pankreasın diğer kistik ve solid lezyonlarından ayırımı güçtür. Yazımızda tesadüfen tespit edilen izole pankreas kist hidatiği vakası sunulmuştur. Kolelitiazisi mevcut olan hastaya çekilen magnetic resonance imaging (MRI)'de pankreas gövdesinde heterojen içerikli kistik lezyon tespit edilmesi üzerine mevcut lezyonun pankreasın kistik malignitesi olduğu düşünülerek hastaya splenektomi ile distal pankreatektomi ve kolesistektomi yapılmıştır. Histopatolojik tanı kist hidatik şeklinde rapor edilmiştir. Pankreas psödokistlerinin ve kistik malignitelerin ayırıcı tanısında pankreas kist hidatiği akılda tutulmalıdır. (Turkiye Parazitol Derg 2015; 39: 75-7)

Review of hydatid cyst with focus on cases with unusual locations

“…It has also been reported that 9.3% of these lesions perforate in a spontaneous way or rupture into the peritoneal space (23). In the differential diagnosis, it is important that pancreatic pseudocysts and cystic malignancies of the pancreas are kept in mind (23). Both of our cases were primary HCs located in the distal pancreas.…”

“…Parasites may settle in almost every site of the body forming primary HC (10). Liver and lung are reported as the most frequent locations, yet unusual sites such as peritoneum, retroperitoneum, spleen, kidney, heart, pelvic, urinary tract, bladder, bone, soft tissue, pancreas, gallbladder, inguinal, supraclavicular, cerebral, spinal cord, and abdominal wall have also been described (4,6,7,(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29). secondary HC mostly occurs after spontaneous or travmatic rupture of a cyst in abdominal cavity when free protoscolices and/or tiny cysts develop to become larger cysts (10).…”

“…Among the pancreas HCs, the head of the pancreas is more frequently involved (57%), followed by the body (24%) and the tail (19%) (21,22). It has also been reported that 9.3% of these lesions perforate in a spontaneous way or rupture into the peritoneal space (23). In the differential diagnosis, it is important that pancreatic pseudocysts and cystic malignancies of the pancreas are kept in mind (23).…”

A Rare Case of Pancreatic Tail Hydatid Cyst with Incidental Adenocarcinoma of the Pancreatic Body

“…Pancreas being a rare location for this disease is not frequently affected even in endemic regions with less than 1% incidence [3]. Isolated pancreas involvement being rare demonstrates distinct features.…”

“…Parasite ova are transported from the small bowel via the hematogenous route; in more than 50% of cases, it affects the liver; it is also able to spread into other organs like the lungs, spleen, brain, bones, retroperitoneal space, and muscles [1-2]. A hydatid cyst is rather rarely seen solely in the pancreas, as in other rare locations it mostly manifests in the pancreas as part of a multiple site involvement [2-3]. Isolated involvement of the pancreas is rare and is mostly seen in endemic regions accounting for nearly 0.2%-1% of the cases [2-4].…”