Primary pancreatic hydatid cyst—a rare case report with review of literature

Hydatid disease is caused by the larval stage of <i>Echinococcus granulosus</i>. It most commonly affects the liver and lungs. Pancreatic hydatid cyst is very rare with incidence of 0.14%-2%. Presenting symptoms vary depending on the location and size ranging from mild non-specific symptoms to less commonly encountered serious pancreato-biliary complications. Due to non-specific symptoms, overlapping imaging features in the early stages and low index of suspicion, the preoperative diagnosis remains a challenge. We present the case of 23-year-old Asian male who presented with complaints of nausea, abdominal pain and vague abdominal lump for 6 months. The patient vague complaints and initial radiological investigations underscore the importance of considering pancreatic hydatid cyst as the diagnosis. Magnetic resonance imaging (MRI) whole abdomen revealed a well defined thick walled cystic lesion in relation to the head of pancreas with undulating membrane noted within the cyst (detached endocyst). The patient underwent open partial cystectomy with omentoplasty along with anti-helminthic therapy. Histopathological findings revealed lamellated membrane with an inner, degenerated germinal layer comprising degenerated protoscolices with hooklets suggestive of hydatid cyst.