The region was drained and the abdomen closed. Postoperative evolution was without complication. The patient was discharged on day 6 post-operative. A 800 mg/day Albendazole therapy lasting 3 months after surgery was started on the patient. After an eight months follow-up, the patient is currently well with neither diabetes nor any signs

of recurrence. Figure 1 Abdominal CT-scan shows a pancreatic cystic mass of 10 cm, with a clean and calcified wall and containing daughter cysts (one arrow). The main pancreatic duct is dilated (two arrows). Between the main pancreatic duct and the cyst, abdominal CT-scan shows a detachement of the hydatid membrane in the pancreatic cyst (dotted arrow). Figure 2 Specimen’s photograph. A- A #find more randurls[1|1|,|CHEM1|]# specimen of the left pancreatectomy with splenectomy, with a tumor in the corpus of the pancreas. B- At the opening of the cyst, we see its own wall and daughter GSK2245840 concentration cysts. Figure 3 Specimen’s photograph shows a fistula between the pancreatic hydatid cyst and the main pancreatic duct (two arrows). The dotted arrow indicates the direction of the migration of hydatid scolices from

pancreatic hydatid cyst into the main pancreatic duct. Discussion Pancreatic location of hydatid disease is rare (less than 1%) compared to the other sites of hydatid disease [1, 2]. The mode of infestation is either hematogenous, when there is a failure of trapping oncospherse by the liver and lung filters, or more rarely

(-)-p-Bromotetramisole Oxalate through lymphatic spread [1]. The location is solitary in the pancreas in 90% of cases. The cyst can be found in the head in 50-57%, in the body in 24-34% or in the tail in 16-19% [3]. Clinical presentation varies according to the anatomic location and potential complications of the cyst (e.g. infection, rupture, biliary or intestinal fistula, segmental portal hypertension, vascular thrombosis, acute or chronic pancreatitis) [3]. With respect to the pathogenesis of pancreatitis, such as liver cysts [12, 13], pancreatic hydatid cysts may cause acute pancreatitis [4–11]. While parasite migration into the common bile duct is advocated as the etiological mechanism to explain acute pancreatitis caused by liver hydatidosis, it remains unclear why some patients affected by pancreatic cysts develop this complication. Accordingly, two hypotheses are posited: main pancreatic duct compression caused by the cyst itself [7] and main pancreatic duct obstruction by hydatid scolices’ migration from the hydatid cyst [6, 8, 9]. To date, and to the best of our knowledge, only 8 cases of acute pancreatitis due to pancreatic hydatid cyst have been reported [4–11]. The mean age of the patients was 28 years, with a range of 18-38 years. The ratio of men to women was 3. The cyst was found in the body (n = 4), tail (n = 2) or head (n = 2). The location was solitarily in the pancreas (n = 7), and associated with a liver hydatid cyst (n = 1) [9].