Extravisceral primary hydatid cyst of the retroperitoneum.
BACKGROUND
Hydatid cyst (HC) continues to be endemic in the Mediterranean countries, such as Turkey. Living in a rural area is an important risk factor for the disease. HC is most commonly seen in the liver and lungs, but retroperitoneal hydatid cyst is very rare. The objective of this study was to evaluate the clinical and radiographic findings and surgical treatment of this unusual lesion.


METHODS
Between 1979 and 2004, 14 cases with primary retroperitoneal hydatid cyst were treated surgically at our clinic.


RESULTS
Symptoms included flank pain in eight (57.1%) and palpable mass in six patients (42.8%). The cyst was located in the right retroperitoneum in seven patients (50%), left retroperitoneum in five patients (35.7%), retrovesical region in one patient (7.1%) and paravesical region in one patient (7.1%). Surgical approaches were right paramedian extraperitoneal approach in four patients, left paramedian extraperitoneal approach in two patients and midline transperitoneal approach in eight patients. Total pericystectomy was chosen as the surgical procedure in all patients except in five (35.7%), who had partial cystectomy for cysts located near the vital structures. There were no complications and mortality postoperatively.


CONCLUSIONS
A primary HC of the retroperitoneum is a distinct clinical entity that must be considered when caring for a patient with a retroperitoneal mass in endemic regions. It should be treated after the diagnosis is confirmed without any delay because of secondary spillages due to perforations and other possible complications.
Aydinli
Bulent
B
Department of General Surgery, School of Medicine, Atatürk University, Erzurum, Turkey. bulentaydinli@gmail.com
Ozturk
Gurkan
G
Polat
K Yalcin
KY
Atamanalp
S Selcuk
SS
Ozbey
Isa
I
Onbas
Omer
O
Akcay
M Nuran
MN
Balik
Ahmet A
AA
Guvendi
Bulent
B
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004443:Echinococcosis / Q000175:diagnosis* / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012187:Retroperitoneal Space