Isolated renal hydatidosis: experience with 20 cases

Abstract

Purpose: Cystic hydatidosis is an endemic disease caused by the larval form of Echinococcus granulosus. It is mostly evident in the liver and lungs, and renal hydatidosis is uncommon. Renal hydatidosis is usually associated with other organ involvement and isolated disease is extremely rare. We present our experience with isolated renal hydatidosis in 20 patients.

Materials and methods: The charts of 20 patients with isolated renal hydatidosis who were hospitalized in our department during a 25-year period were reviewed retrospectively. The clinical, laboratory and radiologic diagnosis, and treatment of these cases are discussed.

Results: The main clinical symptom was lumbar pain. There was no specific or pathognomonic laboratory test for renal hydatidosis except hydaturia, which was present only in 1 patient (5%). Of radiologic examinations computerized tomography had the highest sensitivity and specificity. Treatment was mainly surgical. We performed nephrectomy in 13 patients, and cystectomy and marsupialization in 6. One patient refused all treatments. There was no postoperative morbidity or mortality.

Conclusions: Isolated renal hydatidosis is extremely rare. The main problem is the correct preoperative diagnosis. Although radiologic studies and serological-immunological tests support the diagnosis of hydatid disease, a correct preoperative diagnosis is not always easy. The treatment is mainly surgical, and with appropriate diagnosis and treatment the prognosis is good.