Laparoscopic resection of a bulky primary adrenal hydatid cyst

Abstract

A 55-year-old man with no medical history of relevance was referred to our department for chronic back pain. Plain radiographs of the abdomen showed a round calcified image with liquid level inside in the upper-left quadrant. On computed tomography (CT) a bulky solid-cystic mass with calcified wall of 65 × 34 mm was shown in the left adrenal gland with no-contrast enhancement. The patient underwent a laparoscopic approach. Intraoperatively there was a large hard stony mass depending on the left adrenal gland, which was entirely supplanted by the tumor. Complete excision was done. The patient underwent uneventful recovery. Histopathology examination showed a solid-cystic mass with a thick fibrous wall and calcified areas compatible with hydatid cyst. To date there have been published few cases of adrenal hydatid cyst. To our awareness it is the fourth case issued in all literature resected by the laparoscopic approach.

Incidentally detected hydatid cyst of the adrenal gland: A case report

“…With an incidence of about 0.5%, adrenal hydatid cyst (AHC) disease is rarely seen, even in geographical areas where the disease is endemic[ 3 , 4 ], commonly occurring in the body as part of disseminated hydatid disease. In other words, primary (isolated) AHC is an extremely rare disease[ 8 , 9 ].…”

“…The most frequent symptoms are pain existing due to inflammation in the adjacent tissues caused by the cyst, and those connected with the gastrointestinal system, such as distension, fullness, nausea, vomiting, constipation and loss of appetite[ 4 ]. The most severe complication of AHC disease is the rupture of cyst, causing anaphylaxis and bleeding[ 3 ]. AHC may press on the renal artery externally, but this depends on its size and localization.…”

“…AHC may press on the renal artery externally, but this depends on its size and localization. This condition is called Goldblatt phenomenon, and may lead to arterial hypertension[ 3 , 4 , 7 , 8 ]. An AHC may press on the adrenal medulla, causing pheochromocytoma-like symptoms, such as headache, palpitation and hypertension[ 10 , 11 ].…”

“…Hydatid cysts may occur in the adrenal glands as a primary (isolated) or secondary (associated with the other organs) disease. Cysts may remain asymptomatic for years, or they may be detected incidentally, during the course of radiological examinations conducted for other reasons[ 3 ]. Depending on the size, adrenal hydatid cysts can sometimes lead to complications.…”

Laparoscopic adrenal resection for primary echinococcosis

“…Также могут быть выполнены миниинвазивные катетеризации и аспирации с частичной резекцией капсулы [26]. При возможности сохранения части ткани надпочечника может быть выполнена резекция надпочечника [28][29][30]. Это позволяет сохранить гормональную функцию оставшейся части органа, что особенно актуально для пациентов молодого возраста или пациентов с уже выполненной адреналэктомией с другой стороны.…”