Organ-preserving management of chronic renal hydatid cyst with 10-year asymptomatic progression: a case report.

A 41-year-old male presented with a 10-year history of incidentally discovered left renal cystic lesions on routine examination. Preoperative contrast-enhanced CT and MRI demonstrated multiloculated cystic masses (10 × 8 cm and 10 × 5 cm) suggestive of hydatid disease, with renal scintigraphy showing preserved global function (GFR 87.8 mL/min). The patient underwent successful organ-preserving surgery featuring partial nephrectomy with cyst excision using combined electrocautery and ultrasonic dissection. Surgical management included meticulous adhesiolysis of descending colon/sigmoid colon attachments, dual hypertonic saline scolicidal irrigations (10 min each), and concomitant ureteral stenting for intrinsic stenosis. Histopathology confirmed Echinococcus granulosus infection with characteristic laminated ectocyst and pericystic calcification. The patient maintained disease-free survival at 24-month surveillance, with ultrasonography demonstrating normal renal architecture and complete resolution without recurrence.