Primary pelvic hydatid cyst: a rare case report
Keywords:Echinococcus granulosus, Hydatid cyst, Primary pelvic hydatid, Zoonotic parasitic disease
Primary pelvic hydatid cyst disease is a zoonotic parasitic disease most frequently caused by Echinococcus granulosus or Echinococcus multilocularis. Primary pelvic hydatid cyst is a rare entity. A 39-year-old, para 3 living 3 presented to casualty with acute pain abdomen and a suprapubic mass. Patient gave history of acute lower abdominal pain since 4 days associated with vomiting. On examination, a palpable mass around 18 weeks size, firm to hard in consistency with ill-defined margins and restricted mobility and suprapubic tenderness. Lower limit could not be reached, extending from right iliac fossa to midline. Per vaginum findings suggestive of mass deviated to right side with fullness in right fornix. No cervical motion tenderness. The pre-operative tumor marker levels were as follows: CA125=12.44 U/mL (normal=0-35), CEA=0.09 ng/mL (normal=0-2.5). CA19.9=16.79 U/mL (normal=1.2-30). Erythrocyte sedimentation rate (ESR) was found to be 82 mm in the first hour. Transabdominal ultrasound suggestive of adnexal mass? ovarian with moderate ascites. Urinary bladder seen separately. Contrast enhanced computed topography (CECT) suggestive of complicated right para-ovarian /ovarian cystic mass like cystadenoma. Exploratory laparotomy was done and specimen (uterus, cervix, omental biopsy and peritoneal washings) was sent for Histopathological report. Histopathological examination of the haematoxylin and eosin-stained section revealed ruptured brood capsule releasing daughter cyst. Post-operative period was uneventful. Patient received full course of anti-helminthic treatment.
Ray S, Gangopadhyay M. Hydatid cyst of ovary- a rare entity. J Turk Ger Gynecol Assoc. 2010;11(1):63-4.
Aksu MF, Budak E, Ince U, Aksu C. Hydatid cyst of the ovary. Arch Gynecol Obstet. 1997;261(1):51-3.
Cattorini S, Trastulli D, Milani R, Cirocchi G, Giovannelli N, Avenia F. Sciannameo. Inter J Surg Case Reports. 2011;2(6):100-2.
Ghoshal AG, Sarkar S, Saha K, Sarkar U, Kundu S, Chatterjee S, et al. Hydatid lung disease: an analysis of five years cumulative data from Kolkata. J Assoc Physicians India. 2012;60:12-6.
Hemachander SS, Prasad CR, Jessica M. Morbidity pattern of hydatid disease (cystic echinococcosis) and lack of its knowledge in patients attending Mamata General Hospital, Khammam, Andhra Pradesh. Indian J Pathol Microbiol. 2008;51(1):1435.
Prousalidis J, Tzardinoglou K, Sgouradis L, Katsohis C, Aletras H. Uncommon sites of hydatid disease. World J Surg. 1998;22(1):17-22.
Dede S, Dede H, Caliskan E, Demir B. Recurrent pelvic hydatid cyst obstructing labor, with a concomitant hepatic primary: a case report. J Reprod Med. 2002;47(2):164-6.
Kavitha G, Renukadevi B, Rathna R, Raja R. Primary peritoneal hydatid cyst presenting as ovarian cyst torsion: a rare case report. J Clin Diagnos Res. 2015;9(8):QD07-8.
Aybatlı A, Kaplan PB, Yüce MA, Yalçın Ö. Huge solitary primary pelvic hydatid cyst presenting as an ovarian malignancy: case report. J Turkish Germ Gynecol Assoc. 2009;10(3):181-3.