Renal Cystic Echinococcosis: Long-Term Outcomes of Percutaneous Treatment.

PURPOSE: To evaluate the long-term outcomes of percutaneous treatment of renal cystic echinococcosis (CE) stratified by cyst stages according to the World Health Organization (WHO) classification. MATERIALS AND METHODS: Between January 1997 and February 2019, 34 patients with renal CE (18 women; mean age, 38 years) were treated with 3 different percutaneous techniques. According to the World Health Organization classification, the cysts were classified as CE1, CE2, CE3a, and CE3b. Puncture, aspiration, injection, reaspiration (PAIR) or standard catheterization was used for the dimension-based treatment of CE1 and CE3a cysts. Modified catheterization (MoCaT) was used to treat all CE2 and CE3b cysts. Technical and clinical success, complications, and reduction in cyst cavities were evaluated. RESULTS: The technical success rate was 100%. PAIR, standard catheterization, and MoCaT were used to treat 12, 9, and 13 cysts, respectively. The only severe adverse event was a bacterial superinfection that occured in the cyst cavity of a patient (3%) treated with MoCaT. Four patients (12%) experienced mild/moderate periprocedural allergic adverse events and were managed conservatively. The mean length of hospital stay was 1, 5, and 7 days for patients treated with PAIR, standard catheterization, and MoCaT, respectively. The clinical success rate was 97%. In 1 of 34 cysts (3%), recurrence was detected and the cyst was successfully re-treated. During the 10.5-year follow-up period, 95% volume reduction was achieved. The median final cyst volume was 10 mL. CONCLUSIONS: Renal CE can be successfully treated with minimum adverse events and recurrence rates using appropriate percutaneous techniques selected according to their stages as classified according to WHO.

Primary renal echinococcosis with gross hydatiduria.

Renal echinococcosis is a rare disease. It is usually asymptomatic but may present with pain, lump or in rare cases hydatiduria. Diagnosis is mainly by imaging but serology is usually false negative. We present a patient of renal echinococcosis who presented with passing of grape skin like structures in urine and was diagnosed to be a case of renal echinococcosis on the basis of positive serology, ultrasonographic and CT findings. The patient underwent a nephroureterectomy and was given albendazole preoperatively and postoperatively.

Worms Expelled With the Urine From a Bosniak Cyst III of the Left Kidney.

An old fishman presented with left lumbago and finding worms in his urine. Type-B ultrasonic inspection and computed tomography scan found a Bosniak cyst III, containing several wire-like elements, in the middle of the left kidney. Expelled worms were confirmed to be Dioctophyma renale. After two courses of albendazole, the man was cured.

Amoebic renal cyst: a case report.

Entamoeba histolytica can infect any organ of the body, but only one case of renal involvement has been reported till now in the literature. We report a rare case of amoebic renal cyst in a 78-year showing favorable outcome with metronidazole treatment and therapeutic drainage.

Isolated large hydatid cyst in the kidney of an elderly man.

Cystic disease (CD) is a parasitic infestation by Echinococcus granulosus and occurs endemically in many countries, associated with sheep farming. Renal involvement is rare (2-4%) and is often indicative of disseminated disease. Echinococcal larvae can reach the kidneys through the bloodstream or lymph glands or through a direct route. The larvae grow slowly, and patients bearing larvae are typically asymptomatic. We report the case of a 79-year-old male with an isolated hydatid cyst in the kidney and describe its management by transperitoneal nephrectomy. Diagnosis was based on epidemiology and imaging findings, and was confirmed by histopathological and serum examinations.

Retroperitoneal laparoscopy for the management of renal hydatid cyst.

Hydatid disease is one of the common parasitic afflictions seen in sheep rearing areas of world, with certain areas in northern India showing a very high incidence. It is caused by the larval/cyst stage of Echinococcus granulosus, in which humans are an intermediate host. The cysts are located in liver 75% times, lungs 15%, other organs 10%. Isolated involvement of kidneys is rare and forms 2-4% of cases. The treatment usually requires some form of intervention ranging from minimally invasive percutaneous aspiration techniques to laparoscopic and the maximally invasive, open techniques. Herein, we describe two cases of isolated renal hydatid cysts that were treated successfully by retroperitoneal laparoscopic approach to prevent the soiling of peritoneal cavity. One of the cases had a preoperative diagnosis of simple renal cyst. No complications occurred at peroperative and postoperative periods. The patients were given 3 cycles of Albendazole (10 mg/kg in two divided doses), each for a period of four weeks followed by a weeks rest. The patients are under strict follow-up and no recurrence has been documented yet.

Renal coccidiosis with cystic tubular dilatation in four bats.

Renal coccidiosis was diagnosed in four bats of different species (Pipistrellus pipistrellus, Myotis mystacinus, M. nattereri, and Nyctalus noctula). Multiple white and partly indented foci up to 2 mm in diameter were visible on the renal surface. Histologically, the foci appeared as cystic dilated tubules with proliferated epithelium. Asexual and sexual coccidian stages were seen in the epithelial cells, and the extremely distended tubular lumina were filled with schizonts, free zoites, microgamonts, macrogamonts, and unsporulated oocysts. Because the majority of the renal tissue appeared uninvolved in the disease process at the gross and histologic levels and there was no evidence for uremia in other organs, renal function was probably not impaired. Precise classification of the coccidia was impossible because no sporulated oocysts were available. The parasite morphology and the hitherto unreported cystic dilatation of infected tubules containing all developmental stages differ from renal coccidioses reported previously and therefore suggest an undescribed coccidian species.

Quiste hidatídico renal / Renal hydatid cyst

La hidatidosis es una enfermedad parasitaria, que en nuestro país tiene una frecuencia elevada; principalmente en aquellas regiones con una actividad ganadera importante, con una tasa anual estimada de 5,4 a 7 por 100.000 habitantes. Es una enfermedad frecuente en individuos entre los 15 y 45 años de edad, siendo niños menores de 15 años un 20 a 25 por ciento. La localización renal del quiste hidatídico es rara, alcanzando un 0,2 a 5 por ciento de frecuencia, según las diversas publicaciones. Dada la rareza de esta localización, sumado a la baja frecuencia de hidatidosis en niños; se presentan 2 casos de hidatidosis renal en niños manejados en el Hospital Dr. Exequiel González Cortés y Hospital Militar respectivamente, entre los años 1985 y 1995