Echinococcal lump: An unusual differential diagnosis for a right iliac fossa lump
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CASE REPORT
Echinococcal Lump: An Unusual Differential Diagnosis for a Right Iliac Fossa Lump Madhumita Mukhopadhyay, Sankar Das Chattopadhyay, Nisith Chandra Karmakar, Rina Mukherjee, Partha Sarathi Ghosh, Krishna Pada Rakshit, Sanjay Kumar Mondal, Soumya Ghoshal
Abstract Aim: To report the rare case of a primary peritoneal hydatid cyst in a 65-year-old lady. Case Report: A 65-year-old female presented with a 3-month history of a painless progressive swelling in the right lower abdomen. The lump was 10 cm × 8 cm in size, non-tender, cystic in consistency, and was located in the right iliac fossa and part of the right lumbar region; mobility was restricted in all directions. CECT showed a large septated cystic lesion 14 × 9 × 8 cm in size with enhancement, and sharp regular outline in the right lower abdomen along the anterior aspect of the right psoas muscle. The liver and spleen were not affected. Result: During surgery, a cystic swelling was exposed. Aspiration revealed a clear fluid with some floating material.
The cyst wall was incised and fluid along with daughter cysts were removed keeping the pericyst in situ. Histopathological examination confirmed hydatid disease. Conclusion: Primary peritoneal hydatid cysts, though very rare, should be kept in mind in the differential diagnosis
of a right iliac fossa lump in areas where hydatid disease is endemic. Key words: Hydatid cyst, right iliac fossa, primary peritoneal
Introduction Echinococcus granulosus, or dog tapeworm is endemic in many parts of India [1]. Common sites include the liver (75%) and lungs (15%) [2,3]. The frequency of peritoneal involvement is 13% [4]. Peritoneal involvement is usually secondary. Primary peritoneal involvement without involvement of any other organ in the body is rare [3,5]. We report the case of a primary peritoneal hydatid cyst presenting as a lump in the right iliac fossa.
Case Report A 65-year-old female of poor socioeconomic status presented with a 3-month history of painless progressive
Madhumita Mukhopadhyay MBBS, MS, Sankar Das Chattopadhyay MBBS, MS, Nisith Chandra Karmakar MBBS, MS, Partha Sarathi GHOSH, MBBS, Krishna Pada Rakshit MBBS, MS, Sanjay Kumar Mondal MBBS, Soumya Ghoshal MBBS Dept of Surgery, NRS Medical College and Hospital, Kolkata Rina Mukherjee, MBBS, MS Dept of Pathology, B R Singh Hospital, Eastern Railway, Kolkata Corresponding Author: Dr Madhumita Mukhopadhyay Block 2, 7A, Ekta Heights, 56, Raja S C Mullick Road, Kolkata- 700032, West Bengal, India e-mail: [email protected] Received 22 March 2015; Accepted 6 May 2015
Hellenic Journal of Surgery 87
swelling in the right lower abdomen. She also suffered from low-grade fever in recent months, but there was no history of weight loss, chronic cough, melaena, bleeding per rectum or back pain. On examination, the lump was 10 cm × 8 cm in size, non-tender, with no impulse on coughing. It was cystic in consistency and occupied the right iliac fossa and part of the right lumbar region; mobility was restricted in all directions. Laboratory investiga
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