Adrenal pheochromocytoma masquerading as a hydatid cyst: A case report and review of literature

Hydatid cysts, caused by Echinococcus larval infections, are common in certain regions. In an unusual medical case, a 26-year-old female with a hydatid cyst was unexpectedly found to have an adrenal pheochromocytoma, a rare tumour producing catecholamines. She initially complained of persistent, non-specific right upper abdominal pain. Imaging revealed a cystic lesion resembling a hydatid cyst. During surgery, unexpected arrhythmia and electrocardiographic changes led to the suspicion of acute coronary syndrome, halting the procedure. Further investigation revealed elevated urinary metanephrine levels and a suspicious soft-tissue mass, resulting in laparoscopic right adrenalectomy with hypertensive spikes. The patient was successfully managed, and post-operative examination confirmed the adrenal pheochromocytoma. Hydatid cysts usually present with non-specific symptoms and are diagnosed through imaging. Similarly, diagnosing cystic pheochromocytomas is challenging without typical symptoms, potentially leading to intraoperative complications. Misdiagnosed cases can result in hypertensive crises and hypotension, requiring specific management. Due to their variable presentation and rarity, pheochromocytomas are often misdiagnosed.