Giant pulmonary hydatid cyst in children

Abstract

Background: Lungs are the second most common site for hydatid disease after the liver. Giant hydatid cysts (GHC) of the lung are a special clinical entity in children and are related to higher lung tissue elasticity. Aim: To compare the characteristics on presentation, location of the cyst, type of the intervention, postoperative complications and long-term results in GHC and non-giant pulmonary hydatid cysts (NGHC) in children. Methods: A retrospective study was undertaken. The data analyzed were taken from medical records of pulmonary hydatid cyst (PHC) children hospitalized in a Pulmonary Department between 2004 and 2016. Cysts were divided according to their size into GHC (>10cm) and NGHC (≤10cm). Results: In the period of study, 94 PHC were recorded in 74 children. GHC accounted for 13 (13.8%) and NGHC for 81 (86.2%). Mean age of children was 11.21 years (9.5 in GHC vs 11.5 years in NGHC). Hemoptysis was founded in 25% of children with GHC vs 45.2% in those with NGHC (p=0.19). Cysts were unique in 61.7% of cases and predominated at right in 59.1% and in inferior lobes in 70% of cases. GHC were significantly less frequently complicated (46.2% vs 76.6% in NGHC, p≤0.05). Parenchymal resection was realized in 61.5% of GHC vs 14.8% of NGHC. No significant difference in post-operative complications was found between the two groups. Sequels were found in 58.3% of GHC vs 45.2% of NGHC (p>0.05). Any child had recurrent cyst. Conclusions: GHC is a frequent clinical entity in children because of lower frequency of complications (hemoptysis and rupture) and thus delayed diagnosis. They are associated with more frequent sequels, require major surgery with parenchymal resection and therefore require early diagnostic and therapeutic management.