Primary pleural hydatid cyst

Abstract

Primary pleural hydatid cyst is an uncommon presentation of hydatid disease. We present one such patient with the cyst on the left lateral chest wall masquerading as chronic abscess. A 28-year old lady presented with an enlarging, painless lump in the left chest wall for the last 6 months. There was no history of fever or allergic episodes. She had history of aspiration of thick purulent fl uid from the lesion twice outside. Examination revealed 10x8cm non-tender, cystic swelling between the left 7th and the 8th ribs with round borders and the medial border was not palpable. Cough impulse was positive. Chest X-ray showed a smooth walled homogenous opacity left lower lung overlying the left dome of the diaphragm. Her abdominal sonography was normal. CECT (Figs. 1, 2) showed the presence of a large 16 × 10 cm dumb-bell shaped cystic lesion left pleural space extending from. The cyst cavity showed presence of brood capsules indicating it to be a primary hydatid disease of the pleura. The cyst was excised and patient discharged on Albendazole. It is important to keep hydatid disease as one of the rare but possible differential diagnosis in cystic lesions of the chest wall in this endemic zone. Blind aspiration should be condemned unless a correct otherwise diagnosis is reached.