Retroperitoneal hydatid cyst in an Arab pediatric patient; diagnostic challenges and surgical management: a case report and review of literature.

BACKGROUND

Hydatid cyst disease, caused by Echinococcus granulosus, predominantly affects the liver and lungs, with retroperitoneal involvement being exceedingly rare and posing a significant diagnostic challenge.

CASE PRESENTATION: A 13-year-old Arab girl from a rural area presented with 2 years of episodic abdominal pain and constipation, which progressed to continuous symptoms over the past 2 months. She denied any contact with dogs, sheep, or animals. Imaging revealed a 20 × 10 × 8 cm left retroperitoneal cyst with anechoic contents on ultrasound and a thin-walled hypodense lesion on computed tomography, raising suspicion of a hydatid cyst. Surgical exploration confirmed that the cyst was adherent to retroperitoneal tissues but was distinct from adjacent organs. Endocystectomy was performed. Histopathology confirmed hydatid disease. Postoperatively, adjunctive albendazole was administered for 6 months in accordance with standard guidelines to reduce recurrence rate. Follow-up imaging at 3 months revealed complete resolution with no recurrence.

CONCLUSION

This case underscores the importance of considering hydatid disease in the differential diagnose of retroperitoneal masses in the endemic region, even in the pediatric patient without known zoonotic exposure.