Giant hydatid cysts in pregnancy: A rare presentation

A 23-year-old, 30-week pregnant woman was admitted to our hospital complaining of abdominal pain. Routine laboratory tests were within normal limits. Magnetic resonance imaging (MRI) revealed two unilocular cystic lesions in the VI-VIII and IV segments of the liver of 13 × 14 × 17 cm and 13 × 15 × 16 cm sizes, respectively (Figure 1). The cyst located in the right lobe created pressure on the uterus and fetal sac. The MRI did not detect any other findings that could cause abdominal pain. The patient was followed up for five weeks. Cystectomy and cesarean section were performed under general anesthesia at the 35th week of gestation.

FIGURE 1:
MRI of the abdomen T2-weighted (A) coronal and (B) sagittal images show hyperintense giant cysts (asterisk) in the liver that compress the uterus and fetus (arrows).

The incidence of hydatid disease in pregnancy is 1 in 20,000-30000¹. Cyst rupture is one of the complications of hydatid cyst during pregnancy² that can lead to the death of both the mother and fetus due to anaphylaxis. Pregnant women with hydatid cysts should be closely monitored for such complications. Surgery is the preferred method of treatment in cases diagnosed during pregnancy.

The local ethics committee approval was obtained.

REFERENCES

• ¹
  Junghanss T, da Silva AM, Horton J, Chiodini PL, Brunetti E. Clinical management of cystic echinococcosis: state of the art, problems, and perspectives. Am J Trop Med Hyg. 2008;79(3):301-11.
• ²
  Dede S, Dede H, Caliskan E, Demir B. Recurrent pelvic hydatid cyst obstructing labor, with a concomitant hepatic primary. A case report. J Reprod Med. 2002;47(2):164-6.

• Financial Support: The authors received no financial support for the research and/or authorship of this article.

Publication Dates

• Publication in this collection
  08 Mar 2021
• Date of issue
  2021

History

• Received
  03 Aug 2020
• Accepted
  25 Sept 2020