Excisional treatment of renal hydatid cyst mimicking renal tumor with diode laser technique: A case report.
OBJECTIVE
Cystic echinococcosis, which is one of the most important helminthic infestations, is a serious life-threatening health problem in developing countries. Hydatid cyst of the kidney is a rare condition in children that can be treated with medical therapy or surgical treatment in some resistant cases. Here, we present a case of renal hydatid cyst that was treated with laparoscopic excision with diode laser.


METHODS
A 15-year-old female patient was admitted with abdominal pain. Abdominal ultrasonography revealed a 32 × 23 × 19-mm solid mass with cystic component at lower pole of right kidney. An indirect hemagglutination (IHA) test for echinococcosis granulosus was positive at a 1:320 titer. Other laboratory tests were within normal limits. The patient received albendazole therapy for 3 months. The follow-up magnetic resonance imaging showed a solitary lesion with exophytic extensions that contained large separations. No contrast enhancement could be detected after gadolinium injection. As no regression could be detected radiologically, surgical treatment was planned. Laparoscopic renal lower pole mass cyst excision with diode laser was performed (Figure). The patient was hospitalized for 1 day without any blood transfusion. Histopathological examination was consistent with hydatid cyst of the kidney.


CONCLUSIONS
Diagnosis of hydatid cyst of the kidney is generally made incidentally and can be misdiagnosed as a primary kidney tumor. Radiological studies may be insufficient for accurate diagnosis. In our case, laparoscopic excision of cyst and histopathological examination confirmed the diagnosis of cyst hydatid. At the postoperative second month the ultrasonography of kidneys were normal. For patients from endemic areas, hydatid cyst should always be included in the differential diagnosis. Laparoscopic excision of renal hydatid cysts with diode laser is a feasible and safe technique for resistant cases.
Uludag University Medical Faculty, Pediatric Surgery Department, Pediatric Urology Division, Bursa, Turkey. Electronic address: drmuratucar@hotmail.com.
Murat
M
Uçar
Uludag University Medical Faculty, Pediatric Surgery Department, Pediatric Urology Division, Bursa, Turkey.
Ahsen
A
Karagözlü Akgül
Uludag University Medical Faculty, Pediatric Surgery Department, Bursa, Turkey.
Fatih
F
Çelik
Uludag University Medical Faculty, Pediatric Surgery Department, Pediatric Urology Division, Bursa, Turkey.
Nizamettin
N
Kılıç
D000293:Adolescent; D003937:Diagnosis, Differential; D004443:Echinococcosis / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000175:diagnosis / Q000469:parasitology* / Q000601:surgery*; D007680:Kidney Neoplasms / Q000175:diagnosis; D010535:Laparoscopy / Q000379:methods*; D054023:Lasers, Semiconductor / Q000627:therapeutic use*
Diode laser; Hydatid disease; Laparoscopy; Renal cyst