A Case of Primary Retroperitoneal Hydatid Cyst Causing Secondary Hypertension

Abstract

Hydatid Cyst in the retroperitoneum without lesions in liver, lungs or other organs is a very rare presentation, though, theoretically it can affect any organ of the body except hairs, nails & teeth’s. A 47 year old male patient presented with blood pressure of 200/120 mm hg with left ventricular failure. A giant retroperitoneal cystic mass was seen on USG, suggestive of hydatid cyst. Extensive examination did not show similar lesions in liver, lungs, kidneys or other organs. Renal artery Doppler showed turbulence in the left renal artery with PSV of 250 cm/s and RI 0.7 suggestive of renal artery stenosis. Diagnosis was confirmed on CT scan. Mass was partial removed due to adherence to other organs and histopathology confirmed that it has hydatid cyst. Patient’s blood pressure was under control without medication postoperatively confirming diagnosis of secondary hypertension due to the cyst. Though the diagnosis is difficult, possibility should always be considered before any surgical intervention to prevent accidental spillage and its subsequent complications. Occupational history including history of residence in endemic area along with Ultrasonography, CT scan & Serology helped in the diagnosis of this rare condition. For a giant cyst, total cystectomy is the ideal surgical treatment, though partial cystectomy should be done if its adherent to other organs. Cyst removal will cure the secondary hypertension due to it.