Pseudotumoral form of schistosomiasis mimicking neuroendocrine tumor: a case report and brief review of the differential diagnosis of retroperitoneal masses.

Differential diagnosis of retroperitoneal masses may become complex and requires careful anamnesis, physical examination and several complementary tests. We present the clinical case of a male patient aged 45 years who was diagnosed with a 4cm paraaortic lesion compatible with neuroendocrine tumor in the abdominal computed tomography (CT) exam. The workup performed with SPECT-CT, somatostatin receptors scintigraphy, MIBG scintigraphy, 24-hour urine total and fractionated catecholamines and 24-hour urine 5-OH indoleacetic did not confirm the first diagnostic impression. Finally, the lesion was biopsied and presence of micro-organisms was revealed. Further exams confirmed schistosomiasis as the cause of the paraaortic lesion. Histological diagnosis can be helpful with regard to the differential diagnosis of retroperitoneal masses.

Primary retroperitoneal filariasis: a common disease of tropics with uncommon presentation and review of literature.

Lymphatic filariasis is caused by nematode filariae Wuchereria bancrofti, Brugia malayi or Brugia timori. It is commonly seen in tropical and subtropical regions of the world and affects the lymphatic system of humans, who are the definitive host while mosquito is the intermediate host. The most common manifestation of the disease is hydrocele followed by lower limb lymphoedema and elephantiasis. Although filariasis is much more common entity in north India, its presentation as retroperitoneal cyst is very rare with reported incidence rate of 1/105 000. We present a case of primary retroperitoneal filariasis in a 52-year-old man, without any classic signsandsymptoms, diagnosed postoperatively after surgical resection following diagnostic uncertaintyandfailure of other medical therapies.

First case report of retroperitoneal metastasis of fascioliasis after surgery.

RATIONALE: Fascioliasis is a rare cause of liver abscesses, and its clinical course consists of hepatic phase and biliary phase. PATIENT CONCERNS: We describe a 58-year-old female patient who presented with a 2-month history of intermittent fever and abdominal pain. An abdominal computed tomography (CT) revealed confluent low-density lesions in the liver. Complete surgical resection of these abscesses was performed, and postoperative pathological examination and serological tests confirmed a diagnosis of fascioliasis. However, 4 months after the surgery, follow-up CT revealed a lesion in the retroperitoneal area. Meanwhile, ultrasonography-guided percutaneous needle biopsy of the retroperitoneal lesion was performed, and a parasitic infection was suspected. DIAGNOSES: Retroperitoneal metastasis of hepatic phase fascioliasis. INTERVENTIONS: The patient received parasitic resistance treatment with triclabendazole at a dose of 10 mg/kg/d for 2 consecutive days. OUTCOMES: After 2 courses of triclabendazole therapy, the retroperitoneal metastasis regressed to a minor lesion. LESSONS: To the best of our knowledge, this is the first case report of retroperitoneal metastasis of fascioliasis, aimed at helping recognize the clinical features and treatment options of this rare disease.

Primary retroperitoneal hydatid cyst: a rare case report.

Hydatid disease is a parasitic tapeworm infestation that usually involves liver and lungs. Primary retroperitoneal hydatid without liver and lung involvement is very rare. Surgery is the principle method of treatment for large retroperitoneal hydatid, whenever feasible. We report a case of primary retroperitoneal hydatid cyst in 29-year-old male patient.

[Primary Retroperitoneal Hydatid Cyst]. / Primer Retroperitoneal Kist Hidatik.

Hydatid disease is a parasitosis which is created by Echinococcus granulosus. Hydatid cysts most of ten settled in the liver and lungs. Hydatid cyst is rarely seen in retroperitoneal. Sixty-three year-old female patient was admitted to our hospital with complaints of abdominal distention and with back pain in the Abdominal ultrasonography and computed tomography images, on the posterior of the left kidney, in paravertebral area approximately 15 x 10 cm in size septal cystic lesion was observed retroperitoneally. At laparotomy, partial excision of the retroperitoneal cyst was performed and drainage of the cyst pouch was provided by suction drain. Suction drain was removed 5 days after surgery. Histopathological diagnosis is was reported as hydatid cyst. Hydatid disease is a endemic disease in our country and it should be known that has a typical placements.

[Primary retroperitoneal hydatid cyst]. / Primer retroperitoneal hidatik kist.

Hydatid cysts cause diseases most frequently by localizing in the liver and the lungs. Hydatid cysts with retroperitoneal localization are very rare. A 45-year-old female patient presented to our hospital with complaints of back pain, weight loss, and fatigue. The computerized tomography (CT) revealed that the patient had a septated cystic lesion of about 8x7x6 cm localized in the posterior of the left kidney, in the paravertebral site causing destruction of the neighboring costa. During laparotomy, the wall of the cyst with retroperitoneal localization was partially excised and the remaining cavity was drained. The drain was removed on post-op day 5. The histopathological diagnosis was reported to be a hydatid cyst. No problems were seen during the follow-ups of the patient who was administered post-op albendazole. Hydatid cysts are an endemic disease in our country and it should be kept in mind that they also have atypical localizations.

Pelvic and retroperitoneal hydatid cysts superinfected with Brucella sp. and review of infected hydatid cysts.

Hydatid disease is a zoonotic infection resulting from the tissue infestation of the larval stage of the parasite Echinococcus granulosus. Hydatid cysts superinfected with pyogenic organisms have been reported previously. Brucellosis is more prevalent in people with close contact to animals and those consuming fresh milk or fresh milk products. Although these two disorders have some similar epidemiological features, we did not encounter any hydatid cyst cases superinfected with Brucella species (sp.) in a search of medical literature (Pubmed). Here, we present a case of hydatid cyst disease superinfected with Brucella and review the literature on other hydatid cyst cases superinfected with pyogenic organisms. We conclude that in regions where brucellosis and hydatid cysts are endemic, cysts may be infected with Brucella sp.

[Retroperitoneal hydatidosis secondary to hepatic hydatid cyst]. / Hidatidosis retroperitoneal secundaria a quiste hidatídico de localización hepática.

Hydatid disease is a worldwide zoonosis. It is caused by a parasitic platyhelminth of the genus Echinococcus. We present a patient with a fluctuating lumbar tumor in the retroperitoneal space, secondary to a hepatic cyst. the initial diagnosis was made by identification of rostellar hooks from protoscoleces in the fluid aspirated from the abscess. We herein describe the clinical manifestations, diagnosis and medical and surgical treatment of this unusual case and conclude that the development of an accurate diagnosis requires a proper analysis of the patient's epidemiological history, clinical manifestations, imaging studies and laboratory tests. a multidisciplinary approach and differential diagnosis is paramount to be able to establish a cause of the disease to deliver appropriate treatment.

Case report of primary retroperitoneal hydatid cyst.

Hydatid cyst develops in retroperitoneal space without accompanied lesion in other organs is defined as primary retroperitoneal hydatid cyst. It is extremely rare though hydatid cyst may affect every organ in human body. A 15 years old boy presented with a giant retroperitoneal cyst and hydatid cyst was suspected. Thorough examination did not revealed lesions in liver, lung, kidney or other organs. The diagnosis was confirmed through laparotomy. The diagnosis is difficult, but the possibility should be considered before operation to prevent spillage or fatal anaphylactic shock. Living in an endemic area, ultrasonography, CT or serology test is helpful in the diagnosis of this disease. Total cystectomy is the ideal surgery, if not possible or at high risk, partial pericystectomy is acceptable.

Quiste hidatídico retro-peritoneal: Una enfermedad frecuente en una ubicación inusual / Retroperitoneal hydatid cyst: A common disease in a rare location

Echinococcal disease remains a major problem within some endemic areas. We report a case of a single primary echinococcal cyst located in the retroperitoneal space. A 54-year-old woman, born in a rural area of southern Chile, was admitted with a 3-month history of right hip pain and painful swelling of the gluteal region. Hidatid disease was confirmed with serologic test, radiological examinations and histo-pathology. There were no cysts in any other location. A percutaneous drainage was performed and antihelminthics were administered for 12 weeks and is now being closely followed up, with good response to therapy. Especially in the endemic areas hydatid cyst should be considered when evaluating retroperitoneal cystic masses.

La hidatidosis sigue siendo un problema prevalente en áreas endémicas. Presentamos el caso de un quiste hidatídico primario ubicado en el espacio retro-peritoneal. Mujer de 54 años, procedente de área rural del sur de Chile, hospitalizada por cuadro de coxalgia derecha y aumento de volumen glúteo, con tres meses de evolución. Se realizó el diagnóstico de hidatidosis complicada por medio de exámenes de imágenes, tests serológicos y anatomía patológica. No se demostraron quistes hidatídicos en otras ubicaciones. Se realizó un drenaje percutáneo del quiste infectado y se administraron antihelmínticos durante 12 semanas y actualmente permanece en seguimiento cercano con buena respuesta al tratamiento. El quiste hidatídico debe ser considerado en el diagnóstico diferencial de masas quísticas retro-peritoneales, especialmente en áreas endémicas.

Retroperitoneal filariasis diagnosed by fine needle aspiration: a case report.

BACKGROUND: Filarial worms lodge anywhere, from body fluids to subcutaneous tissue, as various case reports prove. CASE: A 21-year-old Nepali male presented with bilateral groin swellings. Imaging studies showed dilated retroperitoneal lymphatics forming a mass, suggestive of lymphangioma or lymphangioleiomyoma. Fine needle aspiration (FNA) of the retroperitoneal mass revealed microfilariae of Wuchereria bancrofti. CONCLUSION: This is the first reported case of retroperitoneal filarial lymphangiectasia diagnosed on FNA, thus stressing the importance of FNA as a simple yet effective diagnostic tool.

[Retroperitoneal hydatid cyst: a common disease in a rare location]. / Quiste hidatídico retro-peritoneal: Una enfermedad frecuente en una ubicación inusual.

Echinococcal disease remains a major problem within some endemic areas. We report a case of a single primary echinococcal cyst located in the retroperitoneal space. A 54-year-old woman, born in a rural area of southern Chile, was admitted with a 3-month history of right hip pain and painful swelling of the gluteal region. Hidatid disease was confirmed with serologic test, radiological examinations and histo-pathology. There were no cysts in any other location. A percutaneous drainage was performed and antihelminthics were administered for 12 weeks and is now being closely followed up, with good response to therapy. Especially in the endemic areas hydatid cyst should be considered when evaluating retroperitoneal cystic masses.

Splenic hydatid cyst attacking retroperitoneum.

Hydatid disease most commonly affects the liver and lungs but no organ is immune. Splenic hydatid cyst is a rare clinical entity. Although the patients are usually asymptomatic, the disease may present with secondary infection, adhesion to adjacent organs with fistulisation or rupture into abdominal cavity. We present a 67 year old women with splenic hydatid cyst. Severe adhesions and tumorlike growth were found in the retroperitoneal region. To our knowledge, retroperitoneal invasion with a splenic hydatid cyst is a very rare clinical condition. Total splenectomy was performed without complication.

Combined anterior and posterior approach for sacral/retroperitoneal hydatid cyst disease: case report.

Achieving complete resolution of spinal hydatid cyst disease is quite challenging when bone is involved. Many authors reported the poor outcome of posterior decompression and laminectomy for intraosseous spinal hydatid disease. In an attempt to avoid a similar poor outcome, hydatid cysts were reached via both anterior and posterior surgical approaches in our patient. A 73-year-old man presented with complaints of low back and right leg pain. Symptoms or signs of systemic hydatid cyst disease were absent. MRI demonstrated a cystic lesion in the presacral/retroperitoneal region, involving the body of the sacrum and sacral canal. Computed tomography images showed enlargement of the sacral foraminae. The multiseptated cysts and their contents were isodense with cerebrospinal fluid. The cysts were removed via an anterior extraperitoneal approach, using a paramedian vertical incision, and then were also approached posteriorly via bilateral S1 hemilaminectomy. No neurological deficits occurred following surgery. The patient's symptoms completely disappeared after this combination of aggressive surgery and antihelminthic therapy. The application of both anterior and posterior approaches to intraosseous sacral hydatid cysts may be preferred when faced with hydatid disease in this location.

[Giant retroperitoneal hydatid cyst]. / Kyste hydatique rétropéritonéal géant.

Hydatidosis is an endemic, widely distributed anthropozoonosis, which involves the liver, lung and other organs [Int J Urol 13 (2006) 76-9]. We reported the case of a large retroperitoneal hydatid cyst, which is a rare situation [Hepatogastroenterology 48 (2001) 1037-9; Int Urol Nephrol 32 (2000) 41-6; J Urol (Paris) 94 (1988) 445-8]. Diagnosis was suspected with blood tests and radiological examinations. A wide incision in the right iliac fossa (such in renal graft) was performed. The cyst wall was excised partially. Before, during and following the operation, the patient was given albendazole tablets (15mg/kg per day) for 3 weeks (1 week before and 2 weeks after the surgery) with blood count and liver enzyme monitorization. Especially in the endemic areas, hydatid cyst should be remembered when evaluating cystic masses in the retroperitoneum. It can be treated successfully with surgery.

An unusual retroperitoneal sero-negative hydatid cyst presenting with lower urinary tract symptoms.

Hydatid cysts can be found in almost every structure in human body. Thus they can mimic numerous pathologies. Serological analyses are the best assistants in the diagnosis of hydatid cysts. But as serological investigations have limited sensitivity and specificity, they might misdirect our diagnosis. Lungs are the most common involved organ in this parasitic infection. But the brain, muscles, kidneys, bones, heart, pancreas, and rarely the retroperitoneum have also been reported to be involved. An unusual case of a sero-negative hydatid cyst located in the retroperitoneum presenting with lower urinary tract symptoms is reported in this paper.

Primary retroperitoneal hydatid disease mimicking retroperitoneal malignant tumor.

BACKGROUND: Hydatid disease (HD) is endemic in many parts of the world. It may develop in almost any part of the body; the liver is the organ most frequently involved. HD in an unusual location may make differential diagnosis difficult. Isolated retroperitoneal HD is extremely rare. CASE REPORT: We report herein a case of retroperitoneal HD mimicking retroperitoneal malignant tumor. CONCLUSIONS: HD should be considered in the differential diagnosis of all cystic masses in all anatomic locations, especially in regions of the world where the disease is endemic.

Unusual localization of hydatid cyst.

We report a case of a single large echinococcal cyst that originated from the retroperitoneal space. Diagnosis was confirmed with serologic test and radiological examinations. Especially in the endemic areas hydatid cyst should be considered when evaluating cystic masses and it can be treated by extraperitoneal operation.