Giant Primary Splenic Hydatid Cyst Managed by Splenectomy: A Case Report

Giant primary splenic hydatid cysts are extremely rare, accounting for less than 4% of cases of abdominal hydatid disease. The present case reports a 71-year-old male from India presenting with insidious left hypochondrial fullness for 2.5 months without pain, fever, or gastrointestinal symptoms. Physical examination of the patient showed grade 3 splenomegaly, and imaging done using ultrasonography showed a large heterogeneous cystic lesion (19×16×8 cm) in the spleen with peripheral calcification. Total splenectomy was chosen due to the large cyst size and diaphragmatic involvement. Intraoperatively, a tense hydatid cyst that contained approximately 3.5 litres was identified, and an inadvertent diaphragmatic rent found during dissection was also subsequently repaired. The histopathology report of the patient confirmed hydatid disease with a laminated cyst wall and daughter cysts. Postoperative recovery was uneventful, and the patient received appropriate blood support along with post-splenectomy vaccinations. He was advised to undergo albendazole therapy for three months to reduce recurrence risk. The given case highlights the importance of timely diagnosis, multidisciplinary planning, and surgical management of giant splenic hydatid cysts to prevent complications and achieve favourable outcomes.