HYDATID-RENAL-CYST-DISEASE - 22 CASES REV IEWED

Renal involment by Echinococcus granulosus is rare. We review the epid emiology,; clinical symptomatology, diagnostic methods and treatment o f 22 patients with Hydatid renal cyst disease. From 1945 to 1990 we in cluded in the study 13 males and 9 females, with a mean age oi 37.5 +/ - 12.8 (range 14-69). Twenty patients (90.9 %) lived in endemic areas. All the cases were unilateral and the right kidney was involved in 59 % (13/22) and the left in 41 % (9/22). The superior pole was most com monly affected (68.1 %). The clinical symptoms were: lumbar pain (86.3 %), renal colic (45.4 %) and abdominal mass (36.3 %). In only lour pa tients was the preoperative diagnosis correct (Hydatid renal cyst dise ase). In 72.2 % there was only kidney disease, and in 5 patients liver or lung were also affected. The diagnosis was made by KUB, intravenou s urography, ateriography and scanning. Renal echography was used in t he last 7 patients and they presented as pattern IV in three, V in thr ee and III in one patient according to Gharbi(17). Blood test: eosinop hilia was present in 45,4 % of patients. Casoni test was positive in 6 out of 12. Serology: Weimberg test was positive in 2 out of 12 and sp ecific serology (latex, immunoelectrophoresis) was positive in only on e patient. Surgical treatment Mras undertaken in 19 patients: nephrect omy in 10, partial nephrectomy in 5 and excision of the cyst in four. The pathology confirmed the diagnoses oi hydatid cyst in all the patie nts. Only two patients were treated simultaneously with mebendazole. A s Echinococcosis is an acquired renal cyst disease ontogenically diffe rent from other cyst diseases we proposed to call it acquired renal ps eudocyst disease.