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+We present a 63-year-old female patient with a history of arterial hypertension and angor pectoris, referred to our department from a rural hospital. The reason for the consultation was the chance finding of a left renal mass in an ultrasound scan, and the patient did not report any symptoms. Blood tests showed only a slight eosinophilia. As complementary studies, intravenous urographies were performed in which a mass effect was observed at the level of the left flank, with a smooth and well-defined border, depending on the upper pole of the left kidney, with extrinsic compression of the pyelocaliceal system, measuring 16 x 10 cm. CT scan revealed a mass measuring 17 x 12 x 19 cm in the upper pole of the left kidney, with cystic areas, compatible with multilocular cystic nephroma, with no adenopathy. The DMSA scan showed a differential renal function of 63% for the right kidney and 37% for the left kidney.
+
+A new ultrasound scan showed an image compatible with a large hydatid cyst, with structures compatible with vesicles inside. The hydatid serology was negative, so it was decided to submit the patient to an MRI which did not definitively clarify the diagnosis either: mass in the upper pole of the left kidney with a complex internal structure, well delimited, without contrast uptake, with calcifications, suspicious of a renal hydatid cyst or multilocular cystic nephroma.
+In view of the aforementioned results, the next step was the ultrasound-guided puncture of the renal mass, with negative serology for hydatidosis, although a liquid with a crystalline appearance was obtained.
+Finally, the patient underwent surgery in which the diagnosis of hydatid cyst was confirmed and a partial cystectomy was performed, preparing the operative field with compresses soaked in rivanol.
+
+Postoperative evolution was favourable, and treatment with albendazole 400 mg every 12 hours for one month after surgery.
+At the present time, the patient remains asymptomatic (the arterial hypertension she had before diagnosis is maintained) and the control serology was negative again, with minimal eosinophilia persisting.
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