Renal hydatid cyst: Retrospective analysis of 15 cases

To analyze of the various epidemiological, clinical and therapeutical aspects of renal hydatid cyst. In this retrospective study we evaluated 15 cases of renal hydatid cysts treated at the Urology Department of Ibn Rochd University Hospital, Casablanca, between January 2004 and December 2007. The patient group consisted of 7 men and 8 women with a mean age of 40 [range 23-70] years. The parameters studied included the presenting symptoms, the findings on clinical and radiological investigations and the methods of treatment. The patients presented within a mean period of 14 months from the onset of symptoms. Presenting symptoms included pain, hydaturia, hematuria and the presence of a tumoral mass on palpation. Intravenous urography [IVU] revealed calcifications in one patient, a mass lesion in two patients and a non-functioning kidney in one patient. A CT scan of the abdomen was carried out in 6 patients where the radiological examination was inconclusive. However, all patients were subjected to ultrasonography, which remains the diagnostic modality of choice. Hydatid serology was positive in 8 patients. Treatment consisted of unroofing of the cyst in 13 patients and pericystectomy and nephrectomy in one patient each. During the post-operative period 2 patients developed urinary fistulae. After a follow-up of 30 months all patients are symptom-free. In the Maghreb region, where hydatidosis is endemic, the kidneys are rarely affected. The diagnosis of renal hydatid cysts mainly depends on sonography. CT scan is useful in cases with doubtful diagnosis. Magnetic resonance imaging [MRI] is the modality of choice in cases with atypical forms and helps in differentiating a renal hydatid cyst from a serous cyst or cystic renal cancer