| mainly caused by Echinococcus granulosus; however,
renal, ureteral, and testicular echinococcosis caused
by echinococcus multilocularis also have been
reported [1, 2]. Through their life cycle, the eggs of
the parasite hatch in the gut into embryos or larvae
which are also called oncospheres. These larvae
penetrate through the intestinal wall and those managing
to escape the liver are next filtered by the lungs
(9–30 %). Ultimately, these larvae might develop into
aqueous ‘‘blisters’’ called hydatid cysts in the spleen,
(0.9–8 %), kidney (2–3 %), and brain (1 %) [3–5].
We read with great interest the study of the Kumar
et al. [6] titled ‘‘Isolated primary renal echinococcosis:
a rare entity.’’ However, to the best of our knowledge,
the echinococcal larvae may reach the kidneys via the
lymphatic or hematogenous systems or by the direct
invasion from the adjacent intra-abdominal affected
organs. Hence, the kidney involvement is not limited
to the retroperitoneal lymphatics and the portal system
only [1, 2]. Moreover, the echinococcal cysts per se
are not able to pass through lymphatics, the portal
system or the blood stream. Hence, involvement of the
other organs including brain, bone, kidney, etc., is not
due to the cysts but rather to the larvae, oncospheres,
or the scoleces |