case of secondary hypertension due to giant hydatid cyst

ABSTRACT

Hydatid cyst is a parasitic infection which causes enormous morbidity and mortality worldwide. The pathogenic organism responsible for hydatid cyst is Echinococcus granulosus. Despite the fact that the characteristic cysts of the disease usually occur in liver and lungs, they may also occur in aberrant localisations. Subjects either present with symptoms of infection itself or local complications due to compressive mass effect of the cyst. Here, we report a case of secondary hypertension due to extrinsic compression of the right renal artery by a giant hepatic hydatid cyst. A 78-year woman presented with poorly controlled hypertension. She has been treated for hypertension with an angiotensin converting enzyme inhibitor plus calcium channel blocker for the last 2 years. Imaging studies revealed narrowing of the right renal artery and external compression, caused by a giant hydatid cyst. The giant hydatid cyst was treated by cyst aspiration and alcohol injection. Despite cessation of angiotensin converting enzyme inhibitor plus calcium channel blocker, she remained normotensive on follow-up visits. New onset and resistant hypertension cases in elderly should be carefully evaluated for secondary causes of hypertension, including renovascular conditions. Mass effect of the hydatid cyst disease should be considered in the differential diagnosis