An uncommon etiology of adrenal gland mass in infant: primary hydatid cyst

Hydatiddisease is caused by Echinococcus Granulosus, which is a larva endemic in many undeveloped areas. Hydatid disease is relatively uncommon in children. The liver and lungs are most commonly involved, while involvement of other sites in the body is unusual.
We report an uncommon case of hydatid disease located in the adrenal gland space.
This is a 13-year-old Tunisian boy, with left flank pain for three months previously without vomiting, transit disorders or jaundice and evolving in a context of conservation of the general condition and apyrexia. He was from a rural background and of low socioeconomic status. The contact with dogs or sheeps is confirmed. Clinical examination and preoperative imaging have suggested the diagnosis of neuroblastoma or ganglioneuroma or hydatid cyst of the adrenal gland. During the procedure, a hydatid cyst was found occupying the left adrenal gland.
Primary hydatidosis of the adrenal gland in children is extremely rare. Possible sources of infection include blood diffusion or local spread via lymphatic invasion. In the endemic areas, hydatid disease should be mentioned in the list of differential diagnoses of cystic lesions located around the adrenal gland space.