Histopathology, clinical findings and treatment of renal hydatidosis

Renal hydatidosis, although not frequent, is the third location of the echinococcus granulosus in the man, after the liver and lungs. Its clinical importance is remarkable as the natural history of the process (if left untreated) usually results in the opening of the parasitic focus into the excretory ducts and the complete destruction of the kidney. In spite of that, insufficient attention is usually dedicated to the topic. So in the lecture the major aspects of the problem have been considered, also on the basis of histological, clinical and radiological personal studies. The site localisation is essential, and at present is possible on combined modality studies, in particular on diagnostic imaging: plain radiography, conventional urography and new imaging procedures, US, CT and MR, give typical images that definitively prove the specific diagnosis. With regard to treatment, the problem at present is still basically surgical: but nephrectomy (as excessively performed in the past) must be if possible avoided and reserved for cases of parenchymal destruction or of untreatable infection). On the contrary, when it is still possible, one must consider conservative techniques, limited to the removal of the parasite and of permanently damaged parenchymal areas. Cystectomy with resection of the exuberant pericystium or (when possible) segmental resection of the kidney offer a good solution, sometimes also in cases of recurrence.