Ovarian hydatid cyst: A case report

A rare simultaneous occurrence of splenic and ovarian hydatid cyst: A case report

INTRODUCTION AND IMPORTANCE

Hydatid disease is an infectious illness caused by a parasite called Echinococcus. It can affect any organ, primarily the liver and lungs. The occurrence of splenic or ovarian hydatid cyst is rare; simultaneous involvement of both is extremely uncommon. This case report provides valuable insights to clinicians, guiding them to consider a hydatid cyst as a potential differential diagnosis in the presence of a cystic mass lesion.

CASE PRESENTATION

A 33-year-old female presented with abdominal pain of 10 years duration. The past medical and surgical history was negative. Ultrasound and CT scans of the abdomen showed double-layered splenic (15.3 cm × 12.8 cm × 15 cm) and pelvic (8.4 cm × 10.3 cm × 9 cm) cysts. Laparotomy revealed splenic and ovarian hydatid cysts with adhesions to surrounding structures. We performed total splenectomy and left salphingo-opherectomy, yielding excellent outcome.

DISCUSSION

Hydatid cysts of the spleen and ovary are rare, with few case reports. It is usually secondary to systemic dissemination or intra-peritoneal spread from a ruptured hepatic cyst. Imaging modalities such as ultrasound and CT scans can aid in reaching a diagnosis. The standard treatment for a hydatid cyst is surgery.

CONCLUSION

The simultaneous occurrence of hydatid cysts in the spleen and ovary is rare. The diagnosis is challenging due to nonspecific clinical presentations, necessitating a high level of suspicion. Surgery is the primary treatment for hydatid cysts.

Ovarian hydatid cyst: an uncommon site of presentation

Hydatid cyst is a parasitic infestation caused by Echinococcus larvae. Hydatid cyst of the ovary is a highly unusual presentation. Herein, we present a case of a young woman who complained of episodic lower abdominal pain. Ultrasound of the abdomen revealed a multi-cystic left adnexal mass measuring 86 mm x 67 mm. A possibility of ovarian cystic neoplasm was suggested. Unilateral salpingo-oophorectomy was performed. On histopathological examination, a cyst measuring 8.0 x 5.5 x 4.5 cm was found, replacing the entire ovary. The cyst cavity was filled with serous fluid and multiple pearly white membranous structures, giving a multiloculated appearance. Microscopic examination showed a cyst lined by a lamellar membrane containing protoscolices and hooklets. Hydatid disease is a zoonotic ailment caused by tapeworms (Echinococcus granulosus or, less commonly, Echinococcus multilocularis). The definitive hosts are carnivores. Humans are the accidental intermediate hosts. The hydatid cyst commonly affects the liver and the lungs. The primary hydatid cyst of the ovary is quite rare, with few case reports in the literature. In most cases, symptoms are vague, and the lesion is misdiagnosed as benign or malignant ovarian cystic neoplasm on clinical and radiological examination. Ovarian hydatid cyst is treated by surgery with ovarian cystectomy as the gold standard. The possibility of a hydatid cyst should be kept under differential diagnoses while evaluating the cystic diseases of the ovary.

A very rare case of echinococcus granulosus arising in the ovary and the uterus

Hydatidosis is a zoonosis caused by the larval form of a cestode of the species Echinococcus granulosus, the canine tapeworm. It can affect any organ of the human body except nails, hair, and cornea. It most often involves the liver, lungs, muscles, and bones. Involvement of organs in the small pelvis is extremely rare, mainly secondary to dissemination of hydatidosis from another organ, and the ovaries are most often involved, followed by the uterus. We present a 41-year-old Caucasian woman with complaints of mild pain, heaviness in the small pelvis, and a fibroid detected by ultrasound examination. She had reported for 2 previous operations for echinococcus cysts, and we found cystic formations in the liver and pelvis by computed tomography. It was decided that it is a recurrence of echinococcosis with a new cyst both in ovary and uterus. A hysterectomy with adnexectomy was performed, and one year later there is no evidence of recurrence of echinococcosis. In the presence of a formation in the small pelvis, one should always think about echinococcosis, especially if there is evidence of previous manifestations of the disease. Diagnosing this disease is extremely important for proper treatment. As rare as uterine involvement is, this possibility should not be overlooked.

The Neoplasms Mimicker: A Pictorial Review of Hydatid Disease

Hydatid cyst is a common name for the larval stage of a tapeworm species of the genus Echinococcus granulosus, which is transmitted from animals to humans via the fecal–oral route. Hydatid cysts predominantly affect the liver (75%), followed by the lung (15%), and they can affect many organs in the human body. Medical imaging modalities are the keystone for the diagnosis of hydatid cysts with high sensitivity and specificity. Ultrasound imaging with high resolution is the first choice for diagnosis, differential diagnosis, staging, establishing a role in interventional management, and follow-up, and it can differentiate Type I hydatid cysts from simple liver cysts. Unenhanced computed tomography (CT) is indicated where or when an ultrasound is unsatisfactory, such as with chest or brain hydatid cysts, when detecting calcification, and in obese patients. Magnetic resonance imaging (MRI) is superior for demonstrating cyst wall defects, biliary communication, neural involvement, and differentiating hydatid cysts from simple cysts using diffusion-weighted imaging (DWI) sequences. According to the phase of growth, hydatid cysts occur in different sizes and shapes, which may mimic benign or malignant neoplasms and may create diagnostic challenges in some cases. Hydatid cysts can mimic simple cysts, choledochal cysts, Caroli’s disease, or mesenchymal hamartomas of the liver. They can mimic lung cystic lesions, mycetoma, blood clots, Rasmussen aneurysms, and even lung carcinomas. Differential diagnosis can be difficult for arachnoid cysts, porencephalic cysts, pyogenic abscesses, and even cystic tumors of the brain, and can create diagnostic dilemmas in the musculoskeletal system.

Primary Pelvic Hydatid Cyst Mimicking an Ovarian Neoplasm: a Diagnostic Dilemma

Primary pelvic hydatidosis is a rare finding (incidence 0.2-2.25%). An 80-year-old, P6L6, lady presented to our hospital with complaints of PMB and abdominal pain of 5 days with a radiological diagnosis of an ovarian tumor. On pervaginal examination, a firm mobile mass of 6 × 6 cm was palpated in the anterior fornix. Suspecting torsion, semi-elective laparotomy was performed. A mass of 6 × 6 cm was seen arising from the pelvis, adherent to bowel loops, omentum, and bladder peritoneum. Hysterectomy with bilateral salpingo-oophorectomy was performed. No evidence of hydatid cyst was found in liver or any other organs. Final HP report was consistent with ovarian hydatid cyst.

Liver Hydatid Cyst Masquerading as a Liver Abscess

Hydatid cyst of the liver is a rare zoonotic disease in the United States. It is caused by Echinococcus granulosus. This disease is mainly seen among immigrants from countries where this parasite is endemic. Differential diagnoses of such lesions can include pyogenic or amebic abscesses, in addition to other benign or malignant lesions. We report the case of a 47-year-old woman who presented with symptoms of abdominal pain and was diagnosed with a hydatid cyst of the liver masquerading as a liver abscess. Microscopic and parasitological tests confirmed this diagnosis. The patient was treated and discharged without further complications during follow-up.

An Adrift and Homeless Cyst within the Peritoneal Cavity

Introduction

Echinococcosis is a zoonotic infection caused by Echinococcus species. Iran is endemic for Echinococcus granulosus. Here, we present a case of hydatidosis in an 85-year-old man, presented with acute, dull, constant, and generalized abdominal pain. A computed tomography scan (CT scan) showed an intact hydatid cyst on the bladder dome and several hydatid cysts in the liver. Open surgery revealed a cyst with hepatic origin, confirmed with histopathological studies.

Conclusion

Although a primary abdominal hydatid cyst is very rare, it can be transferred to the abdominal cavity without any rupture as secondary ones. In this case, rupture of the liver wall was the reason for this transfer. As a result, there should be a suspicion of hydatidosis in a patient with a similar presentation.

Pelvic Hydatid Cyst: Three Cases with Suspected Adnexal Masses

Hydatid cysts are caused by Echinococcus granulosus. The usual organs in which the parasite lodges are the liver and lungs. One of the most peculiar locations for cyst formation is the ovary and most of these cases are secondary. It has been reported that some cases are formed iatrogenically. In our practice, we encountered three cases of ovarian hydatid cysts with a common symptom of abdominal pain. Imaging studies showed the presence of cystic lesions.Our first case was particularly interesting as the ultrasonographic characteristics were consistent with malignancy; however, surgical intervention showed that she had a hydatid cyst. Of note, this appeared to be a primary cyst because no other lesion was detected at the time. Our second case was diagnosed with infertility and under treatment prior to referral to our centre. Ultrasound (US) imaging showed the presence of a large cyst. The patient underwent laparoscopic cystectomy and the parasitic lesion was removed; however, she was subsequently diagnosed with urticaria and admitted to the intensive care unit (ICU). She made an uncomplicated recovery. Our third case was a pregnant woman with a previous diagnosis of a hydatid cyst. She underwent surgery for a suspected ruptured cyst, which was determined to be parasitic. Due to similarities in appearance, these cysts can be confused with other lesions. Careful management of these cysts in highly prevalent areas must be considered. Despite advanced technology, hydatid cysts present challenges for both surgeons and radiologists.

Hydatid cyst of the ovary - a very rare type of cystic ovarian lesion: A case report

Background

Hydatid disease is a zoonotic condition caused by the adult or the larval stages of tapeworms belonging to the species Echinococcus granulosus or less commonly Echinococcus multilocularis. The presentation depends on the site of involvement. Many cases are not symptomatic and may be discovered accidentally. Hydatid cyst of the ovary is an extremely rare presentation and accounts for 0.2–1% of the diagnosed cases. It may be mistaken for ovarian cysts or cystic tumors of the ovary.

Case Presentation

An 18-year-old woman complained of episodes of lower abdominal pain and frequent urination for the last 3 months. During abdominal examination, there was deep tenderness in the supra-pubic region with no palpable organs or masses. Ultrasound of the abdomen showed evidence of cystic left adnexal lesions. A computerized tomography scan of the abdomen revealed evidence of cystic left adnexal lesion with no enhancement after contrast injection. Laparoscopy was performed and there was evidence of a hydatid cyst of the left ovary. The cyst was extracted from the cavity using a retrieval bag. Anthelmintic medications were prescribed for 3 months, and follow-up ultrasound after 6 months was normal.

Conclusion

A high index of suspicion is required for the diagnosis, particularly in the presence of any cystic lesion, in any part of the world. The enzyme-linked immunosorbent assay test may be informative in the active stages of the disease. Laparoscopic management involves cyst excision. Anthelmintic drugs are required after surgery to decrease the recurrence rate.

•

Hydatid disease is common in certain parts of the world.

•

The diagnosis is mostly radiological.

•

Hydatid cyst of the ovary is often misdiagnosed as an ovarian cyst or tumor.

•

Laparoscopic management involves cyst excision.

•

Anthelmintic drugs are required after surgery to decrease the recurrence rate.

A Fatal and Rare Case of Hydatid Cyst in the Pouch of Douglas

Hydatid cyst is a zoonotic infection and a significant public health problem in low- and middle-income countries. A 79-year-old female patient was presented to the gynecology outpatient department with complaints of pain in the abdomen and difficulty in micturition, with a mass palpable per speculum. The ultrasound was suggestive of an ovarian cystadenocarcinoma, whereas computed tomography of the abdomen favored hydatid cyst with adnexal neoplasm as a differential diagnosis. Considering the contradictory findings, a frozen section was sent to confirm the diagnosis, which showed hooklets of Echinococcus granulosus /hydatid cyst under the microscope. This was a rare case of pelvic hydatid cyst mimicking ovarian malignancy and was associated with a less-preferred mode of investigation (frozen section). This article focuses on how a frozen section, despite its limitations and being expensive, can still be considered for accurate patient management.

Ovarian Carcinoma Uncloaked by Hydatidosis: An Intraoperative Epiphany

Hydatidosis is an infective ailment that is caused by the parasite echinococcus granulosus. The parasitic infection typically produces cysts filled with excessive quantity of fluid and most commonly afflicts the liver. While secondary hydatidosis remains exceedingly rare, cases of hydatidosis in organs such as the ovaries and the fallopian tubes have been documented in the literature. In such instances, the patients present with a vague constellation of symptoms, including abdominal distension and vague abdominal pain. Herein, we elucidate the case of a female patient who presented with massive abdominal swelling on a background history significant for hydatid liver disease. Intraoperative findings included a left adnexal mass, which was eventually established to be an ovarian adenocarcinoma coexisting with secondary ovarian hydatidosis. 

A hydatic cyst of the appendix mimicking a uterine lateral mass: a case report

Background

Hydatic cyst is a zoonotic disease caused by Echinococcus granulosus. It is a public health problem in Tunisia and remains endemic. It occurs in intra-abdominal organs in 10–15% of the cases, particularly in the liver representing the most common affected organ. The aim of the case is to highlight the scarcity of this appendicle origin and to consider it among the differential diagnosis of any intra-abdominal cystic lesion.

Case presentation

A 45-year-old Tunisian woman, with no past medical history, was admitted for a pelvic cystic mass. The clinical manifestation as well as the imaging findings were toward a lateral uterine mass. Our patient underwent appendectomy and resection of the mass. The patient had no recurrence at 2 years of follow-up.

Conclusions

An extrahepatic hydatid cyst should be recognized among the differential diagnosis of any intra-abdominal cystic lesion. Treatment should be based on surgical excision. Due to the risk of recurrence, a close follow-up is mandatory.

Laparoscopic surgery for primary ovarian and retroperitoneal hydatid disease: A case report

RATIONALE

Cystic echinococcosis (CE) is a parasitic zoonosis caused by echinococcus larvae. Manifestations of the disease include a severe damage to the liver and lung. Damages to the mesentery, omentum, spleen, brain, heart, bone, thyroid, kidney, and uterus are rarely observed. Moreover, primary ovarian and retroperitoneal hydatid disease is extremely rare, and is easily ignored or misdiagnosed.

PATIENT CONCERNS

We present a case of CE in a 34-year-old female who presented with an adnexal mass detected by B-ultrasound. Adnexal and retroperitoneal masses were removed by laparoscopic surgery. Postoperative pathological report (retroperitoneal cyst) Echinococcus granulosus.

DIAGNOSES

Primary ovarian and retroperitoneal hydatid disease.

INTERVENTIONS

The patient received intravenous injection of dexamethasone (10 mg) before cyst resection to prevent allergic reactions and oral albendazole (600 mg BID) for 14 days to prevent relapse postsurgery.

OUTCOMES

The patient revealed no recurrence of disease and no reportable significant changes in 3 months.

LESSONS

We present here a case report of CE. This case described herein inhabited a nonendemic region. Gentle and careful operation, and avoiding cyst rupture is the key to insuring success of the surgery. For safety, dexamethasone may be used before cyst resection to prevent anaphylaxis, and mebendazole can be used postoperatively to prevent relapse.

Intraoperative diagnosis of hydatid cyst of the ovary masquerading as tumor

Hydatid disease, caused by the larval stage of Echinococcus granulosus, is found most commonly in the liver and lungs, but no organ is immune. The ovarian involvement is often secondary to a cyst's dissemination localized in a different site. Occasionally, the cyst enlarges, thus mimicking an ovarian tumor. Patients with hydatid cysts at unusual locations present with atypical presentations and pose a diagnostic dilemma. A high index of suspicion is required in order to make a correct diagnosis pre-operatively to prevent spillage of the cyst contents during surgery. We report a case of hydatid cyst in the ovary in a young female. Diagn. Cytopathol. 2017;45:267-269. © 2016 Wiley Periodicals, Inc.

Unusual locations of the hydatid cyst: a review from iran

Hydatid disease is caused by Echinococcus granulosus and is endemic in many parts of the world, including Iran. This parasitic tapeworm can produce cysts in almost every organ of the body, with the liver and lung being the most frequently targeted organs. However, the cyst tends to appear in different and sometimes unusual body sites in various geographical areas of the world. This review provides information on the reported cases of the unusual body sites of the hydatid cyst from Iran in the last 20 years. A literature search was performed through PubMed, Scopus, Google Scholar, IranMedex, Society Information Display (SID), Magiran, and Irandoc using the keywords of "hydatid cyst and Iran" and "Echinococcus granulosus and Iran", and 463 published cases of the hydatid cyst in unusual body sites from Iran were reviewed, evaluated, and discussed. The most common locations were the central nervous system (brain, spinal cord, and orbit), musculoskeletal system, heart, and kidney, while some less common locations were the spleen, pancreas, appendix, thyroid, salivary gland, adrenal gland, breast, and ovary.