THE ENIGMATIC ABDOMINAL MASS: UNVEILING A GIANT CYSTIC ECHINOCOCCOSIS

Abstract

Echinococcosis commonly affects the liver and lungs. Atypical presentations are rarer but pose significant diagnostic and management challenges. We present the case of a 23-year-old female patient, an occupational food runner, who presented with complaints of abdominal distension over a 4-month period. Sonography, CT and MRI pointed to the presence of a large cystic mass in the abdomen, and the differential diagnoses offered were mesenteric cysts or ovarian cysts. Intraoperatively, a 35 × 30 cm cyst with 5 litres of clear fluid was found, and huge sheets of loosely floating brown-coloured membranes noted at the base of the cyst prompted the diagnosis of a hydatid cyst, which was later confirmed by histopathological examination. A high index of suspicion is warranted in endemic areas and one must be aware of the potential challenges associated with atypical presentations.