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Berton GG, Volino GC, de Britto GD, Guerra GC, Júnior JP, Corrêa NB, Taniguchi JB, Comarú LM, Biesek L, Bueno JPC, Lüdtke IN, Marcolan AM, Morassutti AL. Hydatid cysts in the mesocolon mimicking peritoneal pseudomyxoma in a post-appendectomy patient: A case report. Diagn Microbiol Infect Dis 2024; 110:116496. [PMID: 39244842 DOI: 10.1016/j.diagmicrobio.2024.116496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2024] [Revised: 08/13/2024] [Accepted: 08/13/2024] [Indexed: 09/10/2024]
Abstract
We aimed to present a case of two mesocolonic hydatid cysts that mimicked the presentation of peritoneal pseudomyxoma. Hydatidosis is a zoonotic parasitic infection caused by the cestode Echinococcus spp., whose larval stage affects various organs. The present case describes a 40-year-old male patient who presented with severe lower abdominal pain and was diagnosed with acute appendicitis. The patient underwent an appendectomy and was later referred to an oncology surgery clinic because of imaging findings suggestive of peritoneal pseudomyxoma or carcinomatosis. A video-assisted laparoscopic procedure revealed two cysts and microscopic findings confirmed hydatid cysts. The patient was from a hydatidosis-endemic region of southern Brazil. This case highlights the diagnostic challenges and the need for a multidisciplinary approach and careful histopathological analysis in patients with complex abdominal conditions. This also demonstrates the importance of disseminating knowledge about this condition and its management.
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Affiliation(s)
- Giovanni Gosch Berton
- School of Medicine, Universidade de Passo Fundo, Teixeira Soares St., 817, Passo Fundo, Rio Grande do Sul, Brazil; School of Medicine, Università degli Studi di Padova, Ospedale Civile St., 77, Padua, Veneto, Italy
| | - Giovanni Cândido Volino
- School of Medicine, Universidade de Passo Fundo, Teixeira Soares St., 817, Passo Fundo, Rio Grande do Sul, Brazil
| | - Gabriel Diehl de Britto
- School of Medicine, Universidade de Passo Fundo, Teixeira Soares St., 817, Passo Fundo, Rio Grande do Sul, Brazil
| | - Giancarlo Canello Guerra
- School of Medicine, Universidade de Passo Fundo, Teixeira Soares St., 817, Passo Fundo, Rio Grande do Sul, Brazil
| | - Juliano Poleze Júnior
- School of Medicine, Universidade de Passo Fundo, Teixeira Soares St., 817, Passo Fundo, Rio Grande do Sul, Brazil
| | - Nathalia Beck Corrêa
- General Surgery, Santa Casa de Misericórdia de Porto Alegre, Professor Annes Dias St., 295, Porto Alegre, Rio Grande do Sul, Brazil
| | - Juliana Bosso Taniguchi
- School of Medicine, Universidade de Passo Fundo, Teixeira Soares St., 817, Passo Fundo, Rio Grande do Sul, Brazil
| | - Luísa Motter Comarú
- School of Medicine, Universidade de Passo Fundo, Teixeira Soares St., 817, Passo Fundo, Rio Grande do Sul, Brazil
| | - Laura Biesek
- School of Medicine, Universidade de Passo Fundo, Teixeira Soares St., 817, Passo Fundo, Rio Grande do Sul, Brazil
| | - Júlia Papaleo Costa Bueno
- School of Medicine, Universidade de Passo Fundo, Teixeira Soares St., 817, Passo Fundo, Rio Grande do Sul, Brazil
| | - Ivan Neutzling Lüdtke
- School of Medicine, Universidade de Passo Fundo, Teixeira Soares St., 817, Passo Fundo, Rio Grande do Sul, Brazil; Oncological Surgery, Hospital de Clínicas de Carazinho, General Câmara St., 70, Carazinho, Rio Grande do Sul, Brazil
| | - Ana Maria Marcolan
- Pathology Institute of Passo Fundo, XV de Novembro St., 328, Passo Fundo, Rio Grande do Sul, Brazil
| | - Alessandra Loureiro Morassutti
- School of Medicine, Universidade de Passo Fundo, Teixeira Soares St., 817, Passo Fundo, Rio Grande do Sul, Brazil; Pathology Institute of Passo Fundo, XV de Novembro St., 328, Passo Fundo, Rio Grande do Sul, Brazil; School of Dentistry, University of Passo Fundo, BR 285 Rd., Km 292.7, Passo Fundo, Rio Grande do Sul, Brazil.
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Remmerswaal LD, Janes VA, Lamers AB, Koot BG, Stijnis K, Nagelkerke SQ. Echinococcal disease can present with giant abdominal cysts at very young age: A case report. Parasitol Int 2024; 102:102923. [PMID: 39002607 DOI: 10.1016/j.parint.2024.102923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 05/21/2024] [Accepted: 07/10/2024] [Indexed: 07/15/2024]
Abstract
Echinococcus granulosus larvae can cause cystic echinococcosis (CE, also known as hydatid disease) in humans. The latent phase of hydatid disease lasts for years as a result of the slow growth of the cysts, which only become symptomatic when they are large. Therefore, CE is seldomly seen in very young children. Here we present a 4-year-old boy with two giant asymptomatic abdominal cysts. Ultrasound was inconclusive in regard to the nature of the cysts and serology for echinococcosis was negative, rendering CE improbable also in view of the young age. Nevertheless, in the absence of other conclusive explanations, the patient was started on albendazole. A subsequent diagnostic percutaneous puncture with direct microscopy of cyst fluid revealed parasitological evidence of echinococcosis. This case report shows that CE can present with giant cysts also at very young age and should be considered as a possible diagnosis in all children with giant abdominal cysts.
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Affiliation(s)
- Lizzy D Remmerswaal
- Department of Pediatric Immunology, Rheumatology and Infectious Disease, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Victoria A Janes
- Department of Medical Microbiology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Armand B Lamers
- Department of Interventional Radiology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Bart G Koot
- Department of Pediatric Gastroenterology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Kees Stijnis
- Department of Internal Medicine, Center for Tropical and Travel Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Sietse Q Nagelkerke
- Department of Pediatric Immunology, Rheumatology and Infectious Disease, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
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Lone YA, Singh S, Tyagi S, Naaz A, Tiwari BK. Clinical Pattern of Pediatric Hydatid Disease. J Indian Assoc Pediatr Surg 2024; 29:122-128. [PMID: 38616837 PMCID: PMC11014179 DOI: 10.4103/jiaps.jiaps_186_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 11/13/2023] [Accepted: 11/20/2023] [Indexed: 04/16/2024] Open
Abstract
Context Literature regarding hydatid disease in children is sparse. Aims To highlight the peculiarities in the clinical pattern of pediatric hydatid disease (PHD). Settings and Design/Materials and Methods Data were collected retrospectively from all children aged <18 years who presented to our tertiary care institute from July 2021 to June 2023 with hydatid disease involving any organ. Statistical Analysis Used Simple statistical analysis involving sums, means, averages, and percentages. Results Four of the 10 cases (40%) involved the lung, while only 2 (20%) involved the liver. There were five females and four males with an age range of 2-17 years. Four of the cases had primary extrahepatic extrapulmonary hydatid disease (40%), two involving the pancreas, one in the rectouterine pouch, and one intracranial. Conclusions The clinical pattern of PHD is different from that of adults. Pulmonary echinococcosis is more common than hepatic involvement. Primary extrahepatic extrapulmonary hydatid disease is also more common in children than previously thought. A cystic lesion anywhere in a child warrants a differential of hydatid disease.
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Affiliation(s)
- Yasir Ahmad Lone
- Department of Pediatric Surgery, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India
| | - Santosh Singh
- Department of Pediatric Surgery, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India
| | - Shikha Tyagi
- Department of General Surgery, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India
| | - Aisha Naaz
- Department of Pediatric Surgery, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India
| | - Brijesh Kumar Tiwari
- Department of Neurosurgery, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India
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Yağmur I, Kocaman OH, Dere O, Demir M, Katı B, Boleken ME. Multiorgan Echinococcosis with Uterine Involvement Causing Bilateral Hydronephrosis in a Child: Case Report. IRANIAN JOURNAL OF PARASITOLOGY 2022; 17:425-430. [PMID: 36466026 PMCID: PMC9682378 DOI: 10.18502/ijpa.v17i3.10636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 05/10/2022] [Indexed: 06/17/2023]
Abstract
Hydatid cyst is a parasitic infection transmitted by oral ingestion of Echinococcus granulosus eggs. Hydatid cyst of the genital tract is rare and the occurrence in the uterus is an extreme rarity. We present an 8-yr-old girl with complaints of swelling of lower abdomen, pollakiuria and bilateral flank pain was brought to Emergency Department of Harran University, Turkey, in Jun 2019. The patient had simultaneous hydatid cysts of the liver, mesentery and uterus. We performed abdominal exploration and completely removed the inner germinal layer of cyst through an incision made in the anterior of the uterine fundus. Then, we applied total excision to the two cysts in the right and left colon mesentery. Finally, we performed partial cystectomy to the cyst in the liver, and we removed the cyst membrane totally. In endemic regions, hydatid cysts should be considered for the diagnosis of children with cystic mass lesions. Uterine-sparing approach should be kept in mind as an option, especially in young women. Early surgical treatment of large pelvic cysts that cause obstructive uropathy may prevent the progression of renal damage.
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Affiliation(s)
- Ismail Yağmur
- Department of Urology, Faculty of Medicine, Harran University, Şanlıurfa, Turkey
| | - Osman Hakan Kocaman
- Department of Pediatric Surgery, Faculty of Medicine, Harran University, Şanlıurfa, Turkey
| | - Osman Dere
- Department of Radiology, Faculty of Medicine, Harran University, Şanlıurfa, Turkey
| | - Mehmet Demir
- Department of Urology, Faculty of Medicine, Harran University, Şanlıurfa, Turkey
| | - Bülent Katı
- Department of Urology, Faculty of Medicine, Harran University, Şanlıurfa, Turkey
| | - Mehmet Emin Boleken
- Department of Pediatric Surgery, Faculty of Medicine, Harran University, Şanlıurfa, Turkey
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