title: Uncommon primary hydatid cyst occupying the adrenal gland space, treated with laparoscopic surgical approach in an old patient.
abstract: Hydatid disease (HD) is caused by Echinococcus Granulosus (EG), which is a larva endemic in many undeveloped areas. The most common target is the liver (59%-75%). The retroperitoneal space is considered as a rare localization. We report an uncommon case of HD located in the adrenal gland space.
  
  
  METHODS
  This is a 78-year-old Moroccan woman, with right flank pain for eight months previously. She denied contact with dogs or sheep. Her physical examination was normal. There was no pathological alteration of laboratory exams. CT scan measuring 5 cm without clear signs for a sure diagnosis found a round lesion in the right adrenal gland. An abdominal MRI showed a round mass of 34 x 27 mm with fluid component without a clear plane of dissection from kidney and liver. A laparoscopic procedure was performed to obtain a histological diagnosis. We reached a conclusive diagnosis of Hydatid cyst of right adrenal gland space. Hydatid cysts often develop in the liver. The location in the adrenal bed is rare without clinical signs related to alteration of the gland's secretion. Hydatid cyst identification in the adrenal gland space is based on ultrasonography, CT or MRI scans. The differential diagnosis includes various benign and malignant lesions. Laparoscopic procedure is the best approach available to obtain a histological diagnosis and a curative treatment. The best treatment for HD is the pericystectomy. Laparoscopic surgery can guarantee a radical resection of these lesions when it performed by an expert surgeon.
authors.affiliation: Department of General and Minivasive Surgery, University Federico II of Naples, Via Pansini Nr. 5 Postal Code 8010, Napoli, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Aprea
authors.affiliation: Department of General and Minivasive Surgery, University Federico II of Naples, Via Pansini Nr. 5 Postal Code 8010, Napoli, Italy.
authors.forename: Sergio
authors.initials: S
authors.lastname: Aloia
authors.affiliation: Department of General and Minivasive Surgery, University Federico II of Naples, Via Pansini Nr. 5 Postal Code 8010, Napoli, Italy.
authors.forename: Gennaro
authors.initials: G
authors.lastname: Quarto
authors.affiliation: Department of General and Minivasive Surgery, University Federico II of Naples, Via Pansini Nr. 5 Postal Code 8010, Napoli, Italy.
authors.forename: Ermenegildo
authors.initials: E
authors.lastname: Furino
authors.affiliation: Department of General and Minivasive Surgery, University Federico II of Naples, Via Pansini Nr. 5 Postal Code 8010, Napoli, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Amato
authors.affiliation: Department of General and Minivasive Surgery, University Federico II of Naples, Via Pansini Nr. 5 Postal Code 8010, Napoli, Italy.
authors.forename: Tommaso
authors.initials: T
authors.lastname: Bianco
authors.affiliation: Department of General and Minivasive Surgery, University Federico II of Naples, Via Pansini Nr. 5 Postal Code 8010, Napoli, Italy.
authors.forename: Lorenza
authors.initials: L
authors.lastname: Di Domenico
authors.affiliation: Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, Italy. Via Sergio Pansini, 80131 Naples, Italy.
authors.forename: Aldo
authors.initials: A
authors.lastname: Rocca
authors.affiliation: Department of Advanced Biomedical Sciences, University Federico II of Naples, Via Pansini Nr. 5 Postal Code 80100, Napoli, Italy.
authors.forename: Simone
authors.initials: S
authors.lastname: Maurea
authors.affiliation: Department of General and Minivasive Surgery, University Federico II of Naples, Via Pansini Nr. 5 Postal Code 8010, Napoli, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Sivero
keywords: Adrenal Gland; Hydatid disease; Laparoscopic Adrenalectomy; Laparoscopic Pericystectomy; MRI Cystic lesions