Giant primary pancreatic echinococcosis

Hydatid disease, a zoonosis caused by Echinococcus granulosus (EG), primarily affects the liver and lungs. Pancreatic involvement is exceedingly rare, representing only 0.2% of cases. In the reported case of a giant pancreatic hydatid cyst in a 22-year-old female patient. This patient from La Rioja, Argentina, presented with abdominal pain, distension, and early satiety. A CT scan revealed a 16 x 12 cm cyst in the pancreatic head. Preoperative albendazole was administered, followed by a cephalic duodenopancreatectomy due to cyst contact with the superior mesenteric vein. The postoperative period was uneventful, and the patient was discharged on postoperative day five. Pathological examination confirmed a hydatid cyst, with no recurrence at eight months' follow-up. Pancreatic hydatid cysts are rare, with most cases being asymptomatic due to the slow growth of the cysts. Imaging modalities like CT and MRI are crucial for diagnosis, while serological tests can help, although their sensitivity is limited. The treatment approach depends on the cysts location and size. In this case, surgical intervention was necessary due to the size and symptomatic nature of the cyst. The patient's preoperative and postoperative management included albendazole to minimize recurrence risk. Primary pancreatic echinococcosis is a rare manifestation of hydatid disease. This case represents the largest pancreatic cyst reported to date in our knowledge, successfully managed with surgical intervention and albendazole therapy, with no disease recurrence during follow-up. Surgical treatment remains the gold standard for giant or symptomatic cysts.