关键词: 肾棘球蚴病, 棘球蚴病, 误诊

Abstract:

A 41-year-old male, farmer from Kashi, Xinjiang, was presented to Kashi Prefecture Second People’s Hospital on May 15, 2025, with complaints of “intermittent left-sided lumbago for 3 months”. The patient had a clear history of long-term sheep herding, slaughtering, and close contacts with sheep. B ultrasound of the urinary system displayed a left renal cyst complicated by infections. Abdominal CT scanning displayed a round, low-density lesion in the left kidney, measuring approximately 14 cm × 11 cm, and contrast-enhanced CT scans showed no enhancement in the center of the lesion, mild progressive enhancements in the cyst wall and cyst wall nodules, compressed renal pelvis and renal artery, clear surrounding fat space, displaced pancreatic tail by compression, and a lower enhancement intensity of the left kidney than that of the contralateral side. The patient has been diagnosed with a left renal cyst. Based on imaging findings and clinical symptoms, the patient underwent retroperitoneal laparoscopic unroofing and decompression of left renal cyst under general anesthesia on May 21, 2025. Intraoperative findings included a grayish-white, tough cyst wall, clear cyst fluids within the cyst, and daughter cysts and protoscoleces in the cystic cavity. The procedure was converted to excision of left renal Echinococcus cyst. Pathological examination of cyst wall tissues and cystic fluids confirmed the diagnosis of cystic echinococcosis in the left kidney. Oral administration of albendazole was given at a dose of 400 mg twice daily on day 2 post-operation. The patient recovered well and was discharged from hospital on day 8 post-operation. He was instructed to continue albendazole treatment for at least 6 months and to undergo regular follow-up with ultrasonography and liver function tests. No recurrence had been observed until now.

Key words: Renal echinococcosis, Echinococcosis, Misdiagnosis