Superinfected giant renal hydatid cyst with magnetic resonance imaging and intraoperative correlation

Salma Tabati; Chaimae Jebbari; Rayane Bakkaoui; Zineb Labbi; Zainab Iraqui; Omar El Oufir; Laila Jroundi; Ola Messaoud

doi:10.18203/2349-2902.isj20263864

Authors

Salma Tabati Department of Emergency Radiology, IBN SINA Hospital, Rabat, Morrocco
Chaimae Jebbari Department of Emergency Radiology, IBN SINA Hospital, Rabat, Morrocco
Rayane Bakkaoui Department of Emergency Radiology, IBN SINA Hospital, Rabat, Morrocco
Zineb Labbi Department of Emergency Radiology, IBN SINA Hospital, Rabat, Morrocco
Zainab Iraqui Department of Emergency Radiology, IBN SINA Hospital, Rabat, Morrocco
Omar El Oufir Department of Emergency Radiology, IBN SINA Hospital, Rabat, Morrocco
Laila Jroundi Department of Emergency Radiology, IBN SINA Hospital, Rabat, Morrocco
Ola Messaoud Department of Emergency Radiology, IBN SINA Hospital, Rabat, Morrocco

DOI:

https://doi.org/10.18203/2349-2902.isj20263864

Keywords:

Renal hydatid cyst, Cystic echinococcosis, Superinfection, Renal abscess, Magnetic resonance imaging

Abstract

Renal hydatid disease is rare and can mimic a complex renal cyst, abscess, or cystic neoplasm. Preprocedural recognition is essential because inadvertent puncture may cause leakage, dissemination, allergic complications, or infection. A 45-year-old Moroccan man presented with progressive abdominal enlargement and left-sided heaviness. Initial ultrasonography elsewhere showed a giant septated left renal lesion interpreted as a Bosniak II cyst, which subsequently underwent percutaneous puncture. Repeat ultrasonography demonstrated daughter vesicles. Magnetic resonance imaging revealed a 29×28×30 cm left renal cyst with heterogeneous T1- and T2-weighted signal, daughter vesicles, detached membranes, a peripheral low-T2 rim, mild wall enhancement, small gas foci, and heterogeneous diffusion restriction. Surgery demonstrated daughter vesicles and hydatid membranes with purulent material. Histopathology confirmed cystic echinococcosis. Daughter vesicles, detached membranes, and a low-T2 pericyst identify the hydatid origin of a complex renal cyst even when gas, wall enhancement, and restricted diffusion indicate superinfection. Hydatid disease should be considered before puncture or drainage of an atypical renal cyst in endemic regions.

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