Isolated renal hydatid disease (heterogeneous presentations )

Objective: To demonstrate that isolated renal hydatid cysts have heterogeneous presentations. Methods: a retrospective case series study during the period from Jan 2002 to Jan 2007 in the urosurgical department at Al-Jamhory teaching hospital. Five patients with different preoperative diagnoses were dealt with. After their initial clinical assessment and investigating their pathology by lab and imaging studies including IVU and MRI, provisional diagnoses were put and they were explored through lumbar approach and the pathology dealt with accordingly. Results: there were three females and two males with six isolated renal hydatid cysts; mean age 28.8 years. Five cysts involving the left kidney. Their initial diagnoses were pyonephrosis, renal tumor, paracolic abscess, uremia due to large bilateral renal cysts and lower moiety hydronephrosis in a duplicated system. The preoperative diagnosis of renal hydatid was certain in two patients (40%) after cyst aspiration and hydatidiuria; the other three cases were diagnosed intraoperatively, and all cases proved by histopathology. Passing daughter cysts with the stool in a left side renal pathology may help in the diagnosis of a complicated renal hydatid cyst. Conclusion: isolated renal hydatid is a rare disease, has heterogeneous presentations, and preoperative diagnosis may not exceeds 50%, so it needs to be kept in mind in the differential diagnosis of renal space occupying lesion.