Solitary retroperitoneal hydatid cyst masquerading as pseudocyst of pancreas

Abstract

Primary retroperitoneal hydatid cyst is a rarity. Literature on this topic is sparse with anecdotal case reports. Hence the condition poses both a diagnostic and therapeutic dilemma to the attending surgeon. The objective of reporting this case is to highlight the challenges faced by the surgeon in diagnosing and treating this uncommon entity. A 70-year-old man presented with epigastric pain and discomfort accompanied by abdominal mass extending over the epigastric and right hypochondriac region. CECT revealed a cystic lesion in the retroperitoneal, peripancreatic region. The cystic lesion was diagnosed as a primary retroperitoneal hydatid cyst at the time of surgical intervention. Partial cystectomy was performed due to dense adhesions between head of pancreas and the cyst wall. A high index of suspicion for a primary retroperitoneal hydatid cyst is necessary especially in patients who hail from rural agricultural areas. CECT is diagnostic and provides information regarding site, size, nature and relationship to the adjacent organs and blood vessels. Complete cystectomy is the treatment of choice. However, if dissection is difficult then a partial cystectomy with utmost precaution to prevent spillage of contents is the best option.