HYDATID CYST OF THE PERICARDIUM: UNUSUAL MEDIASTINAL TUMOR

Abstract

TYPE: Abstract Publication TOPIC: Disorders of the Mediastinum PURPOSE: HYdatid cyst is a parasitic disease known from the time of Hippocrates, and it is still endemic in many places in the world specially in Mediterranean coast.Here We present the case of a patient with an asymptomatic pericardial hydatid cyst with extension to diaphragmatic muscle. METHODS: A 57-year-old man was referred to our hospital after external bulging of the right heart silhouette was noticed at her chest x rays (CXR) during a preoperative check-up examination for stromal tumor of stomach.An axial postcontrast computed tomogram showed mass with multiple cysts surrounding the right cardiac border, with compression and distortion of the right atrium; and compression of the inferior vena cava (IVC). There was no other cystic lesion in the mediastinal or lung areas. Thorax MRI clearly confirmed the echocardiographic finding, showing small cystic structures inside this mass corresponding to vesicules. There were no cysts detected in the heart. Serologic test (agglutination) for Echinococcus granulosus was positive Abdominal ultrasonography was normal. RESULTS: During right Postero-lateral thoracotomy, pericardio- phrenotomy was practiced around the mass; there is not any extension to myocardium; and the cyst was removed totally without effraction.The follow up was uneventful. Findings from postoperative pathologic examination were consistent with the diagnosis of a hydatid cyst. CONCLUSIONS: Pericardial hydatidosis should be suspected in patients from endemic areas, especially if they have signs of cardiac tumor or when a chest roentgenogram or echocardiogram reveals a mass in relation with the cardiac silhouette. CLINICAL IMPLICATIONS: Essentially the difficulty of diagnosis and surgical techniques without dissemination. DISCLOSURE: No significant relationships. KEYWORD: Hydatid disease Pericardium Surgery