Primary Splenic Hydatidosis: An Institutional Case Series and Review of the Literature

Abstract

Background: Primary splenic hydatidosis is an uncommon manifestation of cystic echinococcosis. Because of its rarity, most available evidence consists of small retrospective series, and the optimal extent of surgery remains debated.

Methods: We retrospectively reviewed 15 consecutive patients with primary splenic hydatidosis who underwent surgical treatment at our institution between 2010 and 2026. Demographic, clinical, radiological, operative, postoperative and follow-up data were collected. A focused review of published case series and contemporary literature was undertaken to place the institutional experience in context.

Results: Fifteen patients were included, with a median age of 38 years; 9 (60.0%) were women. Three patients (20.0%) were diagnosed incidentally. Thirteen patients (86.7%) had solitary cysts and the median maximum cyst diameter was 7.9 cm. Spleen-preserving surgery was performed in 11 patients (73.3%), while 4 (26.7%) underwent total splenectomy. Six patients (40.0%) developed a postoperative complication, predominantly atelectasis and postoperative collections. Two patients (13.3%) developed recurrence during follow-up; both had initially undergone spleen-preserving cystectomy/enucleation with omentopexy.

Conclusion: Our experience reflects the contemporary shift toward spleen-preserving surgery in selected patients with primary splenic hydatidosis. Although recurrence and postoperative collections were observed in the spleen-preserving cystectomy group, the small, retrospective nature of the series precludes comparison of procedures or causal inference.