Abdullah Alaa, Alsafi Reema, Iqbal Jamshaid, Rotimi Vincent
Microbiology Department, Mubarak Al Kabeer Hospital, Kuwait City, Kuwait.
Department of Pathology, Maternity Hospital, Kuwait City, Kuwait.
JMM Case Rep. 2016 Aug 30;3(4):e005057. doi: 10.1099/jmmcr.0.005057. eCollection 2016 Aug.
The diagnosis of hydatid cyst in female genital tract is rare and difficult. A high degree of clinical suspicion is needed for pre-operative investigations to exclude hydatid cyst of female pelvis. The objective of this presentation is to highlight a pelvic hydatid cyst that presented as an ovarian tumour.
A 22-year-old female, presented with constipation and haematuria with acute urinary retention. On examination, a mass measuring 15×13 cm was palpable in the left iliac region reaching up to the umbilicus. It was smooth, movable and non-tender and a provisional diagnosis of ovarian teratoma was made pre-operatively. At laparotomy, a cystic mass was found attached to the broad ligament, excised, and a frozen section was sent for histopathology. Gross features were consistent with hydatid cyst; the cystic wall was white and there were multiple small thin-wall daughter cysts. Microscopic diagnosis with paraffin sections showed cystic lesions with laminated wall and scolices in the daughter cyst. Indirect haemagglutination test for specific antibodies was positive (128 IU). The patient responded well to surgical excision followed by albendazole administration.
This case highlights the fact that a pelvic hydatid disease may resemble neoplastic ovarian cyst, clinically and radiologically. The possibility of pelvic hydatid disease should be included, in endemic areas where differential diagnosis of cystic ovarian lesions is needed, so that the patient can be managed accordingly.
女性生殖道包虫囊肿的诊断罕见且困难。术前检查需要高度的临床怀疑以排除女性盆腔包虫囊肿。本报告的目的是强调一例表现为卵巢肿瘤的盆腔包虫囊肿。
一名22岁女性，出现便秘、血尿伴急性尿潴留。检查时，在左髂区可触及一个大小为15×13 cm的肿块，向上达脐部。肿块光滑、可移动且无压痛，术前初步诊断为卵巢畸胎瘤。剖腹手术时，发现一个囊性肿块附着于阔韧带，将其切除，并送冰冻切片进行组织病理学检查。大体特征与包虫囊肿相符；囊壁呈白色，有多个小的薄壁子囊。石蜡切片的显微镜诊断显示为囊性病变，囊壁分层，子囊内有头节。特异性抗体间接血凝试验呈阳性（128 IU）。患者对手术切除并随后给予阿苯达唑治疗反应良好。
该病例强调了盆腔包虫病在临床和影像学上可能类似于卵巢肿瘤性囊肿这一事实。在需要对囊性卵巢病变进行鉴别诊断的流行地区，应考虑盆腔包虫病的可能性，以便对患者进行相应的处理。
