Aprea Giovanni, Aloia Sergio, Quarto Gennaro, Furino Ermenegildo, Amato Maurizio, Bianco Tommaso, Di Domenico Lorenza, Rocca Aldo, Maurea Simone, Sivero Luigi
Department of General and Minivasive Surgery, University Federico II of Naples, Via Pansini Nr. 5 Postal Code 8010, Napoli, Italy.
Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, Italy. Via Sergio Pansini, 80131 Naples, Italy.
Open Med (Wars). 2016 Nov 19;11(1):413-417. doi: 10.1515/med-2016-0075. eCollection 2016.
Hydatid disease (HD) is caused by Echinococcus Granulosus (EG), which is a larva endemic in many undeveloped areas. The most common target is the liver (59%-75%). The retroperitoneal space is considered as a rare localization. We report an uncommon case of HD located in the adrenal gland space.
This is a 78-year-old Moroccan woman, with right flank pain for eight months previously. She denied contact with dogs or sheep. Her physical examination was normal. There was no pathological alteration of laboratory exams. CT scan measuring 5 cm without clear signs for a sure diagnosis found a round lesion in the right adrenal gland. An abdominal MRI showed a round mass of 34 x 27 mm with fluid component without a clear plane of dissection from kidney and liver. A laparoscopic procedure was performed to obtain a histological diagnosis. We reached a conclusive diagnosis of Hydatid cyst of right adrenal gland space. Hydatid cysts often develop in the liver. The location in the adrenal bed is rare without clinical signs related to alteration of the gland's secretion. Hydatid cyst identification in the adrenal gland space is based on ultrasonography, CT or MRI scans. The differential diagnosis includes various benign and malignant lesions. Laparoscopic procedure is the best approach available to obtain a histological diagnosis and a curative treatment. The best treatment for HD is the pericystectomy. Laparoscopic surgery can guarantee a radical resection of these lesions when it performed by an expert surgeon.
包虫病（HD）由细粒棘球绦虫（EG）引起，EG是一种幼虫，在许多不发达地区流行。最常见的发病部位是肝脏（59%-75%）。腹膜后间隙被认为是罕见的发病部位。我们报告一例罕见的位于肾上腺间隙的包虫病病例。
这是一名78岁的摩洛哥女性，此前右侧胁腹疼痛8个月。她否认与狗或羊有接触。体格检查正常。实验室检查无病理改变。CT扫描发现右侧肾上腺有一个5厘米的圆形病变，但没有明确的确诊迹象。腹部MRI显示一个34×27毫米的圆形肿块，有液体成分，与肾脏和肝脏没有清晰的分界平面。进行了腹腔镜手术以获得组织学诊断。我们最终确诊为右侧肾上腺间隙包虫囊肿。包虫囊肿常发生于肝脏。肾上腺床部位罕见，且无与腺体分泌改变相关的临床症状。肾上腺间隙包虫囊肿的诊断基于超声、CT或MRI扫描。鉴别诊断包括各种良性和恶性病变。腹腔镜手术是获得组织学诊断和根治性治疗的最佳方法。包虫病的最佳治疗方法是囊肿切除术。当由专业外科医生进行腹腔镜手术时，可以保证对这些病变进行根治性切除。
