Isolated renal hydatid presenting as a complex renal lesion followed by spontaneous hydatiduria

Figure 1 Initial ultrasound image reveals heteroechoic indeterminate renal sinus/renal pelvic lesion (white arrow). Doppler revealed negligible vascularity.

Figure 2 Composite of non contrast axial MDCT-post contrast corticomedullary and post contrast nephrographic phases reveals poorly enhancing isodense lesion within the renal pelvis exhibiting calcific specks (white arrow) and hypo-attenuating lesion along its lateral aspect (red arrows). Subtle thickening of the urothelial walls is present.

Figure 3 Delayed oblique coronal multiplanar reformat MDCT image shows the lesion as a filling defect within the collecting system. The lesion and laterally placed cortical cyst are inseparable. Additionally, persistent nephrogram is noted.

Figure 4 Photograph of the fleshy membranes passed spontaneously by the patient few days after ureteroscopy.

Figure 5 Microscopy (magnification 100 ×) revealed characteristic hydatid lamellated layer (arrow) with occasional brood capsules.

Figure 6 Follow up ultrasound revealed normal right kidney.