Bouchikhi Ahmed Amine, Lamrani Youssef Alaoui, Tazi Mohamed Fadl, Mellas Soufiane, Elammmari Jalaledine, Khallouk Abdelhak, Elfassi Mohammed Jamal, Farih Moulay Hassan
Urology Department, University Hospital of Fez, Fez, Morocco.
J Med Case Rep. 2013 Apr 19;7:109. doi: 10.1186/1752-1947-7-109.
Hydatid disease remains a public health problem in many Mediterranean countries. Liver and lung localizations are the most common. Renal hydatid cysts represent 2 percent to 4 percent of the visceral forms of this disease. To the best of our knowledge a scrotal location has only previously been described in five papers in the literature, all being secondary localizations. In this paper, we report a case of a primitive scrotal hydatid cyst.
A Moroccan man aged 29 years old presented to our facility with scrotal pain. A clinical examination identified a painless scrotal mass. The results of a scrotal ultrasound showed intra-scrotal cystic formations with different sizes associated with scrotal effusion of average abundance. Chest cavity and abdominal computed tomography scans did not reveal any other localizations. Our patient benefited from surgical protruding dome resection. A partial cysto-pericystectomy was realized. The first stage consisted of injecting a scolicide solution; hydrogen peroxide is the most commonly used agent. This is injected into the cystic cavity and retained for 10 minutes. This process allows for sterilization of the cyst while avoiding the risk of rupture and transmission of the hydatid liquid into the circulation. After 10 minutes, the cystic contents are removed by suction. The cyst is then opened, and the endocyst containing the hydatid membrane and daughter vesicles are removed. It is of note that our patient did not receive any additional medical treatment. Our diagnosis was made using an imaging approach and was confirmed during surgery.
Ultrasound is often the key diagnostic approach for cases of a scrotal hydatid cyst. Treatment is primarily surgical, aiming for resection of the protruding dome via a longitudinal scrotectomy.
包虫病在许多地中海国家仍然是一个公共卫生问题。肝脏和肺部受累最为常见。肾包虫囊肿占该疾病内脏型的2%至4%。据我们所知，阴囊部位的包虫囊肿此前在文献中仅有五篇报道，均为继发性受累。在本文中，我们报告一例原发性阴囊包虫囊肿病例。
一名29岁的摩洛哥男子因阴囊疼痛前来我院就诊。临床检查发现一个无痛性阴囊肿物。阴囊超声检查结果显示阴囊内有大小不同的囊性结构，伴有中等量的阴囊积液。胸腔和腹部计算机断层扫描未发现其他受累部位。我们的患者接受了手术，切除突出的囊肿顶部。实施了部分囊肿-外囊切除术。第一阶段包括注入杀头节剂溶液；过氧化氢是最常用的药物。将其注入囊腔并保留10分钟。此过程可使囊肿灭菌，同时避免囊肿破裂以及包虫液进入循环系统的风险。10分钟后，通过抽吸清除囊内容物。然后打开囊肿，切除包含包虫膜和子囊的内囊。需要注意的是，我们的患者未接受任何其他药物治疗。我们通过影像学方法做出诊断，并在手术中得到证实。
超声检查通常是阴囊包虫囊肿病例的关键诊断方法。治疗主要是手术治疗，目标是通过纵向阴囊切开术切除突出的囊肿顶部。
