SUPERIOR VENA CAVA SYNDROME SECONDARY TO THE LARGEST REPORTED THORACIC HYDATID DISEASE

Abstract

TYPE: Case Report TOPIC: Lung Pathology INTRODUCTION: Pulmonary Hydatidosis makes up 25% of the cases of hydatid disease cases in endemic areas. We present here, a case of massive pulmonary hydatid disease presenting as tension hydatidothorax* and Superior Vena Cava (SVC) syndrome. *hydatidothorax: We introduce this term for describing the presence of hydatid cysts in the thoracic cavity. CASE PRESENTATION: A 25-year-old gentleman presented with progressive cough, dyspnea, dilation of facial, neck and arm veins and massive facial edema. Chest imaging showed multiple cystic lesions causing opacification of the right hemithorax with a massive mediastinal shift to the left while also compressing the SVC. The patient had refused treatment upon initial, less severe, presentation and only consented when the symptoms became unbearable. The combined size of the cysts was 183 X 209.5 X 333 mm– which we find to be the largest reported collection of hydatid cysts in the lungs. A surgical evacuation of the entire disease was performed and our 3-year post-operative evaluation showed no recurrence. DISCUSSION: SVC syndrome is a rare complication of hydatid disease and even though there is evidence of Cardiac hydatidosis presenting as such, our extensive literature search did not yield a case where pulmonary hydatid disease resulted in the typical presentation of SVC syndrome. Hence, this case expands on our understanding of the mechanical complications arising from the mass effect of progressively increasing hydatidothorax. CONCLUSIONS: Advanced stage of pulmonary hydatid disease can result in SVC syndrome and therefore should be considered in the differential diagnosis especially in patients hailing from endemic regions. DISCLOSURE: Nothing to declare. KEYWORD: Superior Vena Cava (SVC) Syndrome