Hydatid Cyst of the Spleen: Unveiling a Rare Case

Abstract

A 40-year-old female presented at the Outpatient Department of Surgery at Sawangi (Meghe) Wardha with complaints of abdominal pain, fever, and swelling in the left upper quadrant for the past two months. The patient was fine two months ago, but then began experiencing pain and tenderness in the left upper quadrant that radiated to her back. During the local abdominal examination, a soft mass was noted that moved with respiration and could be felt in the left hypochondrium, around 8 cm from the left costal border. No stiffness or guarding was observed. All essential standard investigations were conducted, including hepatic function tests, kidney function tests, and a complete blood count. The laboratory findings were within the normal range except for haemoglobin levels. Contrast-enhanced Computed Tomography (CECT) of the abdomen and pelvis was performed [Table/Fig-1a]. The CECT revealed evidence of a well-defined cystic lesion in the lower pole of the spleen measuring approximately 8×6 cm, with no signs of calcification or internal vascularity. The walls of the cyst were regular, approximately 1-2 mm in thickness. The cyst was displacing the left kidney inferiorly, leading to the suspicion of a hydatid cyst of the spleen based on the CECT findings [Table/Fig-1a]. Subsequent to the report, a splenectomy was performed, and the spleen specimen was sent for histopathological diagnosis {Haematoxylin and Eosin (H&E)}. Grossly, the excised spleen specimen measured 11×9×7.5 cm. Upon cutting the spleen, yellowish fluid oozed out, and a large cystic cavity measuring 8×6×5 cm was identified [Table/Fig-1b]. The cyst appeared yellowish-white in colour [Table/Fig-1c]. Microscopic examination at 100X confirmed the diagnosis of a splenic hydatid cyst, displaying the classic laminated cyst wall encircling scolices with a double layer of hooklets. The histopathological features were consistent with an Echinococcus granulosus infection [Table/Fig-1d].

Keywords

• abdominal pain
• echinococcus granulosus
• left upper quadrant
• splenectomy