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Volume-13 Number-1, 2026 / Case Report

Multiple Disseminated Hydatid Cysts Involving Liver, Retroperitoneum and Uterus: A Rare Case Report

Author:
Md Ibrahim
Department of Pathology, Era's Lucknow Medical College and Hospital, Era University, Lucknow, UP, India - 226003
Nishi Tandon
Department of Pathology, Era's Lucknow Medical College and Hospital, Era University, Lucknow, UP, India - 226003
Andleeb Zehra
Department of Pathology, Era's Lucknow Medical College and Hospital, Era University, Lucknow, UP, India - 226003
Farheen Khan
Department of Pathology, Era's Lucknow Medical College and Hospital, Era University, Lucknow, UP, India - 226003
Nirupma Lal
Department of Pathology, Era's Lucknow Medical College and Hospital, Era University, Lucknow, UP, India - 226003
Abstract:
Background: Hydatid disease is a helminthic illness carried and transmitted from animals to humans and between humans and caused by the cestode Echinococcus granulosus. The liver and lungs are the primary sites of infection, and thus are most commonly affected, and are hence the most vulnerable. The disease is very uncommon and of a somewhat peculiar clinical type with widely disseminated and multifocal infiltration of the abdominal viscera; little is known for its appearance as a manifestation in the uterus.
Case Presentation: The present case concerns a 46-year-old woman who had suffered for almost two and a half decades from an enigmatic clinical history consisting of recurrent attacks of abdominal pain of unknown etiopathogenic origin. She did not have any other significant co-pathologies or significant past disease on the list that would be clinically relevant for presentation besides the one mentioned above. However, a special pattern of abnormalities was found, with numerous distinctive, fluid-filled cysts scattered throughout the right liver lobe (segments V and VI), the right iliac area and right lumbar area, and the uterus, by abdominal ultrasonography.
In sum, it is a clinical and pathological constellation that could be interpreted as no longer any question: this is disseminated hydatid disease with multifocal involvement of different anatomical territories of the corporal scan. She was then taken to the operating room and a detailed removal of the cystic lesions was performed at the same time as a vaginal hysterectomy. An extensive and detailed histopathological examination was carried out on specimens of the cystic wall which were taken from the hepatic, retroperitoneal and uterine areas; the pathologist was able to make an absolute diagnosis and absolute diagnostic certitude.
The cysts were all the classic trilaminate pattern characteristic of this type of entity with a dense outer granulation tissue (pericyst) directly derived from host tissue, a laminated acellular chitinous outer cyst (ectocyst) and a delicate inner lining of flattened germinative cells (endocyst). The endometrium exhibited benign cystic hyperplasia and cervix benign features of chronic cervicitis with nabothian cysts.  Serology for echinococcosis was not performed. The patient was started on albendazole after surgery and recovered without complications.
Conclusion: We describe an unusual case in which hydatid disease involved not only the liver and retroperitoneum but also the uterus — a site that is rarely implicated. This case underscores the need to consider disseminated hydatidosis when evaluating multifocal cystic lesions, particularly in regions where the parasite is endemic.
 
Keywords:
Hydatid cyst; Echinococcus granulosus; Disseminated hydatid disease; Uterine hydatid cyst; Histopathology

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Copyright (c) 2026 Era's Journal of Medical Research

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Download PDF View in DOI 10.24041/ejmr.2026.20