A Rare Case of Splenic Hydatid Cyst Managed by Surgical Removal

Abstract

Primary isolated splenic hydatid cyst is an uncommon manifestation of echinococcal disease, even in endemic regions reported in only 0.5-4 % of cases. Due to non-specific clinical features and radiological resemblance to other splenic cystic lesions, diagnosis is frequently delayed, increasing the risk of complications such as rupture, secondary infection, and anaphylaxis. This report describes a rare case of a 35-year-old female who presented with chronic left upper abdominal pain accompanied by nausea, reduced appetite, and intermittent low-grade fever. Clinical examination revealed mild splenomegaly. Ultrasonography identified a large calcified cyst located in the upper pole of the spleen, with no evidence of hepatic or pulmonary involvement. Serological testing for echinococcosis supported the diagnosis.

Given the cyst’s size and potential for rupture, surgical intervention was planned. Laparoscopic splenectomy was initially attempted; however, dense adhesions between the cyst and the diaphragm with a high risk of intraoperative spillage necessitated conversion to open splenectomy. The spleen was removed intact, and the postoperative course was uneventful. Histopathological examination confirmed the diagnosis of splenic hydatid disease.

This case emphasizes the importance of including hydatid disease in the differential diagnosis of isolated splenic cysts, particularly in endemic regions. It also highlights the value of timely surgical decision-making and demonstrates that open splenectomy remains a safe and definitive treatment option for large, adherent splenic hydatid cysts when minimally invasive approaches are unsuitable.