Complete Laparoscopic Excision of a Primary Isolated Mesenteric Hydatid Cyst With Radiological Features Suggestive of Inactivity

Primary isolated mesenteric hydatid cysts are uncommon, and management is uncertain when imaging suggests an inactive lesion.We describe a 25-year-old patient in whom an abdominal mass was incidentally identified during a routine examination.An initial abdominopelvic computed tomography scan revealed an approximately 8-cm supravesical cystic lesion suspicious for a degenerating hydatid cyst.Magnetic resonance imaging showed a thickened, calcified wall, complex internal fluid, and no abnormal enhancement.Cerebral and thoracoabdominal imaging disclosed no other suspected hydatid focus; Echinococcus serology was negative.After specialist multidisciplinary assessment, surgery was selected because of lesion size, its unusual supravesical location, and concern about possible compression of adjacent structures, despite imaging features suggestive of inactivity.The cyst was excised laparoscopically in one piece without intra-abdominal rupture or bowel resection, and was removed in a retrieval bag.Histopathology was compatible with a remodeled, calcified/ossified hydatid cyst wall, although Echinococcus polymerase chain reaction did not detect Echinococcus DNA.No perioperative albendazole was administered.Recovery was uncomplicated, discharge occurred on postoperative day 2, and the patient remained clinically well at three months.This report illustrates a carefully selected laparoscopic approach while emphasizing that evidence supporting surveillance of inactive hepatic cysts cannot be directly generalized to isolated mesenteric lesions.