A case of left adrenal echinococcosis misdiagnosed as a left renal cyst: Case report

RATIONALE: Echinococcosis is a zoonotic parasitic disease caused by Echinococcus larvae, with high prevalence of cystic echinococcosis and alveolar echinococcosis forms in western China. Clinical manifestations depend on cyst location, size, and complications. It is associated with animal husbandry in endemic regions and is considered an occupational disease in exposed populations. PATIENT CONCERNS: A 10-year-old patient was admitted following imaging identification of a left renal cystic lesion. Computed tomography revealed a 6.5 cm × 5.5 cm non-enhancing cystic mass in the left subphrenic region and hepatorenal space. Laboratory results: complete blood count, biochemistry, hormonal assays, and urinalysis - were within normal limits. Based on age and clinical presentation, a preliminary diagnosis of simple renal cyst was made. DIAGNOSES: The patient underwent laparoscopic partial cystectomy. Intraoperatively, the cyst was found to originate from the adrenal gland. Histopathological and immunohistochemical examination confirmed adrenal echinococcosis. INTERVENTIONS: The patient underwent laparoscopic partial cystectomy. OUTCOMES: The cyst originated from the adrenal gland. Histopathological and immunohistochemical examinations confirmed it as adrenal echinococcosis. LESSONS: When diagnosing renal cystic lesions, do not conclude hastily from routine imaging and prelims. Consider rare causes like adrenal echinococcosis. Do serological tests, stress differential diagnosis to avoid misdiagnosis.