Yousuf A Husen, Naila Nadeem, Fawad Aslam, Imran Bhaila.
Primary Splenic Hydatid cyst: a case report with characteristic imaging appearance.
J Pak Med Assoc Jan ;55(5):219-21.

A middle-aged lady presented with pain, tenderness and swelling in the left hypochondrium since one month. She had a history of contact with dogs and grazing animals. Sonography and computed tomography showed the pathognomonic signs of hydatid disease. The patient refused surgical treatment. She was discharged on Albendazole therapy and did not return for a follow up. Case Report: A 55 year old diabetic lady presented with mild pain, tenderness and swelling in the left hypochondria) region of one month duration. She had a history of previous hospitalisation due to uncontrolled diabetes. Physical examination revealed a slightly pale, overweight lady. The abdomen was soft and a mass was detected in the left hypochondrium. Rest of the physical examination was unremarkable. Sonography showed a well defined round mass; eight cm in diameter of mixed echogenecity with undulating membranes arising from the medial aspect of the spleen. Computed tomography (CT) scan revealed a well defined circular mass in the posterior part of the spleen with curvilinear calcification inside, producing a whirl shaped appearance. No enhancement was noted after injection of intravenous contrast. Differential diagnosis at this stage was an old cyst with calcification or a splenic neoplasm. Routine laboratory investigations were normal. Echinococcus antibody titres were 1:64 (Normal 1:32). At this stage, history of contact with dogs or grazing animals was obtained which was positive. A splenectomy was planned but the patient refused to have surgery. She was discharged on Albendazole therapy and did not return again for follow-up.

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