Case Report
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Radiol. Jul 28, 2015; 7(7): 180-183
Published online Jul 28, 2015. doi: 10.4329/wjr.v7.i7.180
Isolated renal hydatid presenting as a complex renal lesion followed by spontaneous hydatiduria
Anil Bhaya, Archana P Shinde
Anil Bhaya, Department of Radio Diagnosis, Apple Hospitals and Research Institute Ltd., Kolhapur 416001, India
Archana P Shinde, Department of Pathology, Apple Hospitals and Research Institute Ltd., Kolhapur 416001, India
Author contributions: Bhaya A contributed to concept, design, preparation of manuscript, literature search and final review; Shinde AP contributed to patient diagnosis, provided diagnostic inputs.
Institutional review board statement: As this was an outpatient and study observational case report on only one patient hence IRB approval was not obtained.
Informed consent statement: All involved subjects have provided their written/verbal consent for performance of all diagnostic studies and inclusion in this case report. The subject has been made aware that all identifying data has been removed and kept confidential.
Conflict-of-interest statement: The authors declare no financial, professional or personal conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Anil Bhaya, MD, DNB, CCST, Senior Consultant and HOD Advanced Imaging, Department of Radio Diagnosis, Apple Hospitals and Research Institute Ltd., 525/E, Vyapari Peth, Shahupuri, Kolhapur 416001, Maharashtra, India. anilbhaya@hotmail.com
Telephone: +91-231-2651207 Fax: +91-231-2654850
Received: February 26, 2015
Peer-review started: February 27, 2015
First decision: March 20, 2015
Revised: April 14, 2015
Accepted: May 7, 2015
Article in press: May 8, 2015
Published online: July 28, 2015
Processing time: 141 Days and 18.3 Hours
Abstract

Echinococcosis is a zoonotic disease. Liver is the most common site of involvement. Renal involvement is seen in 2% to 3% of patients. Computed tomography findings in renal hydatid typically include: a cyst with thick or calcified wall, unilocular cyst with detached membrane, a multiloculated cyst with mixed internal density and daughter cysts with lower density than maternal matrix. Rarely type IV hydatid cysts may mimic hypovascular renal cell carcinoma. We report a case of previously asymptomatic middle aged female who presented with mild intermittent pain and a complex renal lesion on imaging which was considered to be a hypovascular renal carcinoma or urothelial neoplasm. However, by serendipity, the patient had spontaneous hydatiduria and later was definitively diagnosed and stented. Hydatid disease should always be considered amongst the top differential diagnosis of an isolated “complex” renal lesion which remains indeterminate on imaging.

Keywords: Hydatidoses; Echinococcosis; Hydatiduria; Kidney diseases; Cystic; Hydatid; Renal

Core tip: Renal hydatid is generally secondary to disseminated hydatidoses or associated with hepatic involvement. Isolated renal involvement is far less common and reported in less than 5% of all hydatid cases. Without appropriate history a subset of renal hydatid, especially type 4 cyst may simulate cystic renal/urothelial neoplasm or other complex cystic lesions such as abscess. Radiologists must harbour a high index of suspicion and look for subtle imaging signs such as calcification and non enhancing “solid” component to include this diagnosis in the differential of complex renal lesion. Absence of relevant history or hepatic involvement should not prevent diagnosticians from entertaining this rare diagnosis.