A complex renal cyst: it is time to call the oncologist?

Area of Science:

• Urology
• Parasitology
• Infectious Diseases

Background:

• Hydatid disease is a cyclozoonotic parasitic infestation caused by Echinococcus granulosus.
• Typically affects the liver (50-70%) or lungs (20-30%), with other organ involvement complicating diagnosis and treatment.
• Isolated renal hydatidosis is exceptionally rare.

Observation:

• A 71-year-old male presented with abdominal pain, anemia, fever, and microhematuria.
• Ultrasonography revealed a complex cyst in the right kidney with internal echoes.
• MRI confirmed findings consistent with hydatid cyst disease.

Findings:

• Right nephrectomy was performed, with histopathology confirming a hydatid cyst.
• The patient received a 4-week course of albendazole (10 mg/kg/day), split pre- and post-operatively.
• Microscopic examination confirmed the diagnosis of hydatid cyst.

Implications:

• Isolated primary renal hydatidosis must be considered in the differential diagnosis of cystic renal masses.
• This rare condition can mimic other renal pathologies, necessitating a high index of suspicion.
• Early and accurate diagnosis is crucial for appropriate management and patient outcomes.