Giant Isolated Hydatid Cyst of Spleen - Giant Isolated Hydatid Cyst of Spleen - Open Access Pub

Liver is most commonly involved organ in hydatid cyst. Primary splenic hydatid cysts are rare; we report a case of an isolated giant hydatid cyst of spleen in a 17-year-old man. The diagnosis was confirmed by imaging findings and serology. Partial cystectomy was performed with success. In cystic lesions of spleen, hydatid cyst should be kept in patrician’s mind in the differential diagnosis. Although splenectomy is the gold standard for treating hydatid disease of the spleen, in young patient spleen-preserving surgery seems give good results. DOI 10.14302/issn.2578-2371.jslr-14-543 Hydatid disease is a helminthic anthropozoonosis with worldwide distribution that is caused by the larval stage of Echinococcus granulosus 1. Liver and Lungs are the most common sites of involvement in adults. Echinococcal cysts are mostly found in the liver and lungs but the disease can occur almost anywhere in the body 1. Usually, splenic involvement in hydatid cysts follows systemic dissemination or intra peritoneal spread following ruptured hepatic hydatid cyst. Primary hydatid disease of the spleen is very rare even in endemic areas 2. We report a case of an isolated giant hydatid cyst of spleen of a 17-year-old man. Treated successfully by a spleen-preserving surgery. A 17-year-old young man admitted to our department with the complaint of abdominal pain localized in the left upper quadrant for the last 3 months. His physical examination revealed a splenomegaly. Immunoblot assay for Echinococcus was positive. His laboratory tests showed normal results of the serum and urine examinations, No eosinophilia was found. Chest X-ray revealed no pathological signs. An abdominal ultrasonography showed a 20 cm multivesicular cystic mass of spleen (figure 1). Contrast enhanced CT scans detected a huge single 20×16×18cm cystic mass located in the spleen. It had well-defined borders and contained multiple, round, daughter cysts in the periphery of the lesion with calcification (Figure 2, Figure 3, Figure 4). The patient underwent a laparotomy. A large splenic cystic mass was identified, attached to diaphragm, and tail of the pancreas (figure 5). The abdomen was packed with 10% hypertonic saline soaked pads in order to protect peritoneal soilage. A partial cystectomy without splenectomy was performed. Histologic examination of the specimen resection showed an echinococcal organism residing within the hydatid cyst . The patient was discharged after 4 postoperative days. 600 mg per a day of Albendazole therapy was instaured postoperatively and continued for 6 months. Two years after