Renal Hydatid Cyst Mimicking Renal Cell Carcinoma

Case Report

Austin J Urol. 2015;2(3): 1028.

Renal Hydatid Cyst Mimicking Renal Cell Carcinoma

Sidani MN, Graziano CE, Soni SD and Smith TG*

Department of Urology, University of Baylor, USA

*Corresponding author: Smith TG, Department of Urology, University of Baylor, 7200 Cambridge Street, Houston, TX, 77030, USA

Received: September 28, 2015; Accepted: October 20, 2015; Published: November 04, 2015


Hydatid cyst disease occurs as an isolated infection of the urinary tract in 2-4% of cases. With the rise in immigration from endemic areas into developed nations, reported cases in nations like the United States of America are increasing. Our goal is to shed light on this rare tropical disease in an effort to encourage physicians to include this entity in their differential diagnosis of a renal mass.

A 33-year-old man presented for evaluation of chronic flank pain and frothy urine with fleshy white clots. CT and MRI imaging showed a large multilobular cystic renal mass, which was suspicious for renal cell carcinoma. The patient underwent a radical nephrectomy and a pathologic diagnosis of renal hydatid cyst was reached.

Symptoms of renal hydatid cyst are highly variable and non-specific. Ultra sonography and CT may be helpful to reach a diagnosis and distinguish this disease from renal cell carcinoma, but supplemental blood work-up is often necessary. Therapy entails a combination of surgical and medical approaches.

Renal hydatid disease can be easily confused with the cystic form of renal cell carcinoma Thus, in an effort to shed light on this condition; we have summarized the most distinctive features of renal hydatid cyst disease.

Keywords: Echinococcus; Renal cell; Cyst; Hydatid


Hydatid disease is a rare infection caused by the parasite Echinococcus granulose. The parasite is transmitted via the fecaloral route and dogs, the definitive host, become infected after eating the organs of animals infected with hydatid cysts. Humans are an intermediate host who can become infected after the ingestion of food or water contaminated with the fecal matter of an infected dog. The disease is endemic in regions where stockbreeding is a major trade [1]. Infection is initiated when the ingestion of an egg containing an embryo crosses the mucosal lining of the intestine and gains access to the liver via the portal vein. In the liver the embryo becomes arrested and develops into a hepatic hydatid cyst. However, if the embryo enters the pulmonary circulation it can produce pulmonary cysts, and may continue on to the peripheral circulation and to other organs including the kidney or brain. The kidney is the third most common location for cyst formation [2]. Renal hydatid disease may lead to significant morbidity from urinary symptoms and flank pain, and may cause renal deterioration. Furthermore, spontaneous cyst rupture into the peritoneal cavity resulting in death from systemic anaphylaxis has also been reported [3].

With the rise in immigration to the United States over the past two decades (Figure 1), the number of reported cases of echinococcosis in North America has been increasing [4]. Moreover, the World Health Organization has classified the disease as a Neglected Zoonosis subgroup for its 2008– 2015 plan for the control of Neglected Tropical Diseases [5].