Diagnosis and treatment of renal hydatid disease: presentation of four cases.
Hydatid disease of the urinary tract is uncommon, accounting for only 2% to 1% of all hydatid diseases. We report 4 patients with hydatid cystic disease of the kidney. Nephrectomy was performed on 1 patient because of the destruction of renal parenchyma by the hydatid cyst. The other 3 patients were treated by cystectomy to preserve the normal renal parenchyma. In these cases, Casoni's intradermal test and indirect hemagglutination (IHA) test were not found to be helpful in the diagnosis, and eosinophilia was not significant. Diagnostic features of hydatid cysts were mixed echogenicity on ultrasonography, and multivesicular cyst with mixed density on computerized tomography (CT). CT was the most useful and specific investigation. No complications were noted during the first 3 months of the follow-up. Despite its rarity, hydatid disease should be considered in the differential diagnosis of space-occupying lesions of the urinary tract. Parenchyma-sparing surgery (cystectomy, partial nephrectomy) or nephrectomy are the main treatment modalities.