Percutaneous treatment in a type 4 renal hydatid cyst

We present percutaneously effective treatment with povidone iodine of a case with type 4, intermediate subtype renal hydatid cyst according to Gharbi et al.'s classification, including both solid and fluid content in almost equal quantity. So far, 11 renal hydatid cysts in the three series have been treated percutaneously; neither is type 4, nor is treated with povidone iodine as scolecidal agent. This was performed on a 62-year-old male patient who refused surgical treatment. The patient had applied to our hospital with pain, swelling and tenderness in his right upper abdomen, malaise and fetid breath odor for 2 months. Ultrasonography showed heterogeneous cystic mass with solid components. There was no other organ involvement and no relation with the pelvicaliceal system on computed tomography. Oral albendazole was given for a week after which percutaneous intervention was performed, yielding the definitive diagnosis pathologically. There were larvaes and scolices in the cytology of the cyst. The percutaneous treatment of the hydatid cyst was managed with irrigation of 0.9% NaCl and 10% povidone iodine. Two catheters were used for two separate loculations. Follow-up until the 31st month revealed no cystic recurrence. This is the first report to the best of our knowledge, of the effective percutaneous treatment of the type 4, intermediate subtype renal hydatid cyst. Further reports are needed.