SFEBES2023 Poster Presentations Adrenal and Cardiovascular (78 abstracts)
A rare case of hydatid cyst disease in the adrenal gland
Ali Al Jumaah 1,2 , Miles Levy 1,2 , Shailesh Gohil 1,2 , Neil Bhardwaj 2 , Martin Wiselka 2 , Emma Bremner 2 , Mary Barrowcliffe 2 & Narendra Reddy 1,2
1University of Leicester, Leicester, United Kingdom. 2University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
Introduction: Hydatid cysts disease (HSD) is a parasitic disease caused by echinococcus granulosus. It is common in areas where the parasite is endemic; North Africa, the Middle East, Central and Far Asia, Central America and Australia. Liver (44-77%) and lungs (10-50%) are the preferred locations for HSD. Here we report a rare case of HSD affecting the adrenal gland.
Case report: A 62-year-old female complained of right abdominal pain for a few weeks. CT scan showed a large right upper quadrant cyst measuring 14.7x12.4x11.6cm with calcified margins. It was inseparable from the right adrenal gland and contains fluid level with pressure effect on the liver and the right kidney. Further scans showed no evidence of other cysts in the chest. The patient denied contact with animals but had been travelling to South East Asia and South Africa many years ago. She received 3-month course of Albendazole followed by surgical removal of the intact cyst. Examination of the cyst material confirmed the diagnosis of HSD with no viable parasite. Albendazole was stopped two weeks after the surgery with no complications.
Conclusion: Hydatid cysts of the adrenals are extremely rare. So far, only 57 cases have been reported. This case represents the UK first known case HSD of the adrenal gland. Once suspected, biopsy must be avoided due to risk of spillage of cyst contents and septic shock. The treatment of choice is by removing the intact cyst via open laparotomy. Final diagnosis can only be confirmed after histological examination of the excised cyst.
Learning point: 1. Consider HSD as a differential diagnosis when evaluating adrenal cyst especially following exposure to endemic areas.
2. Avoid biopsying cyst of suspected parasitic origin as it can cause serious complications.
3. Laparotomy as opposed to laparoscopic resection is recommended to remove intact cyst capsule.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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