Presentation
Epigastric pain, vomiting and jaundice in patient had previous cholecystectomy
Patient Data
There is a subcapsular multiloculated cyst in segment 6 of the liver measuring approximately 4.7 x 4.9 cm with rim calcification. Possible hydatid.
The spleen contains a 3.3 cm hypoattenuating lesion which is probably a cyst but better characterized on ultrasound.
Numerous bilateral renal cysts are present.
The complex partially calcified cyst in the liver likely represents a hydatid cyst.
The splenic lesion along the inferior aspect has some ill-defined margins on ultrasound which is likely presence of a daughter cyst.
Multiple renal cortical cysts are seen but there is one cyst in the mid pole of the left kidney and one cyst in the lower pole of the right kidney which contain septation/daughter cyst and underlying hydatid cyst.
Case Discussion
This patient presented with multiple cysts involving multiple organs. Follow up ultrasound showed multiple different types of cysts:
- stage 1 (homogeneously hypoechogenic cystic thin-walled lesion) involving the kidney and spleen
- stage 2 (septated cystic lesion) involving the kidneys and the spleen
- stage 3 (cystic lesion with daughter lesions) involving the kidneys
- stage 5 (calcified or partially calcified lesion (inactive cyst)) in the liver
Patient was commenced on albendazole 400mg bd and praziquantel 40mg/kg in 2 divided doses (4 tablets) twice a week.
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