Table of Contents  
CASE REPORT
Year : 2016  |  Volume : 9  |  Issue : 5  |  Page : 661-662  

Primary ovarian hydatid cyst


1 Department of Pathology, Late Shree Baliram Kashyap Memorial Government Medical College, Jagdalpur, Chhattisgarh, India
2 Department of Anatomy, Late Shree Baliram Kashyap Memorial Government Medical College, Jagdalpur, Chhattisgarh, India

Date of Web Publication13-Oct-2016

Correspondence Address:
Sachin A Badge
Department of Pathology, Late Shree Baliram Kashyap Memorial Government Medical College, Jagdalpur, Chhattisgarh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0975-2870.192158

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  Abstract 


In humans, hydatid cyst is caused by Echinococcus granulosus. E. granulosus mainly affects the liver and lungs. It is very rare to get a primary ovarian hydatid cyst. Hence, we are reporting a very rare case of primary ovarian hydatid cyst.

Keywords: Cyst, hydatid, ovary


How to cite this article:
Badge SA, Kujur MA, Meshram AT, Ovhal AG. Primary ovarian hydatid cyst. Med J DY Patil Univ 2016;9:661-2

How to cite this URL:
Badge SA, Kujur MA, Meshram AT, Ovhal AG. Primary ovarian hydatid cyst. Med J DY Patil Univ [serial online] 2016 [cited 2024 Mar 29];9:661-2. Available from: https://journals.lww.com/mjdy/pages/default.aspx/text.asp?2016/9/5/661/192158




  Introduction Top


The major cause of human hydatid cysts is Echinococcus granulosus. This infection is more common in countries where people keep cattle, sheep, and dogs near their living places.[1] These countries belong to the Mediterranean region, Middle Europe, South America, Middle East, East Africa, and Australia.[1] Humans play the role of accidental intermediate hosts. Usually, the duration of cyst formation from the ingestion of the eggs by a host up to the symptomatic stage of the disease is 10-20 years.[1] The route that larvae choose to spread is through penetration of the intestinal wall, and most of them enter the portal vein to reach the liver. Seventy percent of these larvae are captured by the liver while the remaining 30% escape the hepatic filter. E. granulosus mainly affects the liver (63%), lungs (25%), muscles (5%), bones (3%), kidneys (2%), brain (1%), and spleen (1%).[1] It is rare to diagnose a hydatid cyst in the pelvis, especially as a primary localization.[2] The incidence being given as 0.2-2.25%. In 80% of cases reported with a cyst in this location, the ovary is the most commonly affected organ followed by the uterus.[3] Cases of primary ovarian hydatid cysts are reported, but more commonly, ovarian involvement is secondary to a cyst's dissemination from another site.[4]


  Case Report Top


A 55-year-old female patient presented with the compliant of abdominal pain for 2 months. Ultrasonography of abdomen and pelvis showed a cystic lesion in the left ovary. Rest of the abdominal and pelvic organs were normal. Left oophorectomy was done, and the specimen was sent for histopathological examination. On gross examination, there was an ovary with a pearly white cyst measuring 4 cm in diameter. On cutting, there was serous fluid and no daughter cysts inside. On microscopy, there was a cyst wall having laminar membrane [Figure 1]. As liver and other organs did not have cysts on sonography and there was also no history of hepatic hydatid cyst, this case was labeled as primary ovarian hydatid cyst.
Figure 1: Hydatid cyst wall having laminar membrane (×40)

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  Discussion Top


Ovarian hydatid cyst is a very rare finding. Patients with hydatid cyst of the ovary have been reported from Saudi Arabia, Ethiopia, India, and other regions.[5],[6],[7],[8] All these reports revealed the low incidence of primary involvement of the ovary as a site of hydatid cyst formation. Pelvic echinococcosis symptomatology is nonspecific and can include abdominal tumefactions, abdominal pain, menstruation irregularities, infertility, and urinary disturbances.[9] Ovarian echinococcosis can simulate either polycystic disease or malignancy. The difficulties that occur in making a correct diagnosis are due to the nonspecific clinical symptoms, associated with atypical ultrasonographic and radiological images which merely show a solid ovarian mass.[10] A high grade of suspicion or a preoperative diagnosis of Echinococcus cyst makes it possible to avoid an intraoperative iatrogenic rupture, and when available, to administer previously an albendazole-based therapy to reduce the risk of dissemination that can lead to recurrences. The ultrasound scan, especially if performed transvaginally, is an important imaging tool to recognize the cystic aspect of the lesion, showing the characteristic fluctuating membranes of the multilocular cyst. Computed tomography (CT) scan confirms the diagnosis revealing daughter cysts and contingent calcifications of the cyst's wall. The treatment of choice in ovarian hydatid cysts is surgery which could be either radical or conservative. Care must be taken to reduce the risk of possible cyst's rupture. Ovarian cystectomy, when possible, represents the gold standard treatment. In some cases, this approach is not possible in the need to preserve surrounding structures. In these circumstances, a partial cystectomy or marsupialization taking all the necessary precautions not to spill daughter cysts together with anti-helminthic therapy to reduce the chance of recurrence are alternative acceptable approaches. Cases of hydatid cysts aspirated using saline agents are reported.


  Conclusions Top


An ovarian hydatid cyst is a rare finding. To diagnose this pathology, one must have a high grade of suspicion. Transvaginal ultrasonography and abdominal CT are the best methods of imaging available to avoid an intraoperative break. When possible, the optimal treatment is radical laparotomic cystectomy.

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Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
Aksu MF, Budak E, Ince U, Aksu C. Hydatid cyst of the ovary. Arch Gynecol Obstet 1997;261:51-3.  Back to cited text no. 1
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2.
Basaranoglu M, Sonsuz A, Perek A, Perek S, Akin P. Primary pelvic hydatid cyst. J Clin Gastroenterol 1998;26:157-8.  Back to cited text no. 2
    
3.
Díaz-Recaséns J, García-Enguídanos A, Muñoz I, Sáinz de la Cuesta R. Ultrasonographic appearance of an echinococcus ovarian cyst. Obstet Gynecol 1998;91(5 Pt 2):841-2.  Back to cited text no. 3
    
4.
Uchikova E, Pehlivanov B, Uchikov A, Shipkov C, Poriazova E. A primary ovarian hydatid cyst. Aust N Z J Obstet Gynaecol 2009;49:441-2.  Back to cited text no. 4
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Adewunmi OA, Basilingappa HM. Primary ovarian hydatid disease in the Kingdom of Saudi Arabia. Saudi Med J 2004;25:1697-700.  Back to cited text no. 5
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Gaym A, Abebe D, Degefe DA. Hydatid cyst an unusual cause of ovarian enlargement. Ethiop Med J 2002;40:283-91.  Back to cited text no. 6
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Konar K, Ghosh S, Konar S, Bhattacharya S, Sarkar S. Bilateral ovarian hydatid disease — An unusual case. Indian J Pathol Microbiol 2001;44:495-6.  Back to cited text no. 7
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8.
Gamoudi A, Ben Romdhane K, Farhat K, Khattech R, Hechiche M, Rahal K. Ovarian hydatic cyst 7 cases. J Gynecol Obstet Biol Reprod (Paris) 1995;24:144-8.  Back to cited text no. 8
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Dede S, Dede H, Caliskan E, Demir B. Recurrent pelvic hydatid cyst obstructing labor, with a concomitant hepatic primary. A case report. J Reprod Med 2002;47:164-6.  Back to cited text no. 9
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Aybatli A, Kaplan PB, Yüce MA, Yalçin O. Huge solitary primary pelvic hydatid cyst presenting as an ovarian malignancy: Case report. J Turk Ger Gynecol Assoc 2009;10:181-3.  Back to cited text no. 10
    


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