Mediastinal Hydatid Cyst Research Articles

Masse médiastinale antérieure d’étiologie rare

Hydatid cyst of the mediastinum is very uncommon. The diagnosis, usually evident in endemic regions in the case of a typical clinical-radiological presentation, is rather more difficult in certain atypical forms. We report a case of a 19-year-old man who presented with a mass of tumour like appearance in the anterior mediastinum. The diagnosis of mediastinal hydatid cyst was established by transthoracic needle biopsy and endoscopic bronchial aspiration revealed hydatid membranous debris. The diagnosis was confirmed when the mediastinal cyst ruptured into a bronchus. Thoracotomy was carried out with an uneventful post-operative recovery. This observation illustrates the diagnostic difficulties when a mediastinal hydatid cyst presents the appearances of a tumour. This possibility must be included in the differential diagnosis of every mediastinal mass, particularly in endemic regions.

Primary mediastinal hydatid cyst causing a paralysis of the recurrent nerve

Hydatid cyst disease stills a health problem in Morocco. We describe a rare case of a mediastinal hydatid disease that developed in the left thoracic cavity, and associated with paralysis of the left recurrent laryngeal nerve. Paralysis of thoracic nerve (phrenic nerve, sympathetic …) to the best of our knowledge, there is only one case report of paralysis of the left recurrent laryngeal nerve secondary to compressive effects from mediastinal hydatid cysts.

Quiste hidatídico mediastínico: Reporte de un caso y revisión de la literatura

Hydatid disease is caused by the larval stages of a cestodes belonging to the genus Echinococcus. In humans, hydatid larva and cysts are located >90% in the liver and/or lungs. Primary mediastinal location, with absence of documented lung infection, is extremely rare and has not been previously reported in Chile. We report the first case of a primary mediastinal hydatid cyst in Chile and review the literature. A 38 year old woman was admitted because of a painful right supraclavicular mass, dyspnea on exertion and logical dysphagia. Presurgical evaluation evidenced a mediastinal tumor extending to the cervical region that was successfully removed. The diagnosis of mediastinal hydatid cyst was confirmed macroscopically and by biopsy.

Hydatid cyst involving the aortic arch

We report a very rare case of primary mediastinal hydatid cyst which invaded the ascending aorta and the aortic arch which initially presented as a cranial mass. Aortic wall is a very unusual site for the hydatid cysts. To the best of our knowledge, this is the first reported case of hydatid cyst located within the aortic arch lumen. Patient underwent ascending aortic and hemiarch replacement under hypothermic circulatory arrest and removal of the cyst. Patient had an uneventful recovery and has been on follow-up. Although the literature data are very limited, we believe that the aortic procedure of choice should be graft interpositon rather than patch repair.

Kyste hydatique primitif du médiastin : 14 cas

Purpose The objective of this study was to describe the different radiological features of the hydatid cyst of the mediastinum. Materials and methods We conducted a retrospective study on 14 patients (seven women, seven men), diagnosed with mediastinal hydatid cyst, aged 13-67 years (mean, 48 years) over a period of 16 years in our hospital where 71 cases of hydatid disease are annually diagnosed. The patients were explored by chest radiography ( n=14), chest ultrasonography ( n=10), abdomen ultrasonography ( n=14), computed tomography (CT scan) ( n=13), and magnetic resonance imaging (MRI) ( n=8). Results The chest x-ray showed an opacity of the anterior ( n=11), middle ( n=1), and posterior ( n=1) mediastinum. The thoracic ultrasound confirmed the liquid nature of the mass with a multivesicular aspect ( n=9). CT and thoracic MRI made it possible to precisely locate the mediastinal compartment involved and study the relationship to adjacent structures. A purely mediastinal location was found in only six cases. In the remaining cases, it was associated with hepatic ( n=7) and pleural ( n=1) locations. Conclusion Hydatid cysts of the mediastinum are very uncommon. Diagnosis can be made by chest sonography. CT scan is the main tool for diagnosis and the study of possible extension. Our study showed a more frequent location to the anterior mediastinum.

Mediastinal Hydatid Cyst Rupturing into the Pleural Cavity Associated with Pneumothorax: Case Report and Review of the Literature

Hydatid disease remains a serious health problem in Mediterranean countries. Living in a rural area is an important risk factor for the disease. Hydatid cysts are usually located in the liver, lungs and brain. Mediastinal hydatid disease is very rare and has been noted only anecdotally in the literature. The present article reports a case of a mediastinal hydatid cyst rupturing into the pleural cavity, which was associated with pneumothorax of the same side. The patient's previous chest x-rays (posteroanterior and left lateral views) showed a well-defined mediastinal mass on the left side, and contrast-enhanced computed tomography of the thorax (taken a few days after the chest x-ray) showed multiple round-to-oval soft tissue opacities with partial collapse of the left lung. An indirect hemagglutination test for echinococcus was positive. Even after two weeks of intercostal tube drainage, the patient's condition did not improve. During thoracotomy, multiple daughter cysts were found in the pleural cavity, and the diagnosis of a hydatid cyst was confirmed after histopathological examination.

Suppurated Mediastinal and Cardiac Echinococcosis: Report of a Case

We herein report the case of a suppurated mediastinal and cardiac hydatid cyst which occurred after the initial treatment of the patient for a primary mediastinal hydatid cyst in a radiology department. Both extracorporeal circulation and total circulatory arrest were used during the operation. We believe that surgery is the only feasible treatment for hydatid cysts located in the mediastinum, and surgery should be urgently performed whenever a possible rupture is suspected in order to avoid a possible anaphylactic reaction, mediastinal suppurations leading to serious complications, and growth into the pleural cavity.

Unusually located intrathoracic extrapulmonary mediastinal hydatid cyst manifesting as Pancoast syndrome

Hydatid cyst still remains an important problem in developing countries. It can appear in any place throughout the body and is more common in the liver (75%) and lung (25%). The lung is the second most common site of location, but because of its elastic properties, hydatid cyst seldom shows intrathoracic compression signs and symptoms unless the size is too huge. Compression signs and symptoms can be seen when the cyst is located in the extrapleural or mediastinal region. A few cases of hydatid cyst have been reported as a benign cause of Pancoast syndrome in the English literature. Here we present an unusual compression of extrapleurally located mediastinal hydatid cyst causing Pancoast syndrome.

Primary hydatid cysts of the mediastinum.

Hydatid disease remains a serious health problem for the Mediterranean countries, such as Turkey. Living in a rural area is an important risk factor for the disease. Hydatid cysts are usually located in the liver, lung, and brain. Mediastinal hydatid disease is very rare that have been only anecdotally in the literature. The objective of this study was to evaluate the clinical and radiographic findings and surgical treatment of this unusual lesion. Between 1985 and 2002, 11 cases with primary mediastinal hydatid cyst were treated surgically at our clinic. Median age was 28.4 and ranged from 19 to 46 years. Symptoms included chest pain in nine patients (82%), and cough in six patients (54%). The cyst was located in the anterior mediastinum in four patients (36%), in the posterior mediastinum in five patients (45%) and in the middle mediastinum in two patients (18%). All cysts were intact except one cyst that ruptured into right intrapleural space. Surgical approach was right thoracotomy in five patients (45%), left thoracotomy in three patients (27%), and median sternotomy in three patients (27%). Total pericystectomy was chosen as the surgical procedure in all patients except four (36%), who had cystectomy and local curettage for cyst located vital structures. There were no complications and mortality postoperatively. Primary hydatid cysts of the mediastinum are distinct clinical entity that must be considered when caring for a patient with a mediastinal mass in endemic regions. Because of surrounding vital structures the cyst should be treated without delay.

New diagnostic signs in hydatid disease; radiography, ultrasound, CT and MRI correlated to pathology

Seventeen of 70 patients with hydatid disease had verified Echinococcus granulosus infection of the chest. In 14 patients (20%), the primary location was the lung parenchyma. Two patients had primary and one secondary mediastinal hydatid cysts, and one patient a primary hydatid cyst of the chest wall. In three above-mentioned patients, secondary pleural involvement occurred, of which two were due to ruptured pulmonary cysts and one due to an hydatid cyst arising in the liver and having prolapsed into the chest. In all cases, clinical findings, radiography, ultrasound (US), computed tomography (CT) and/or magnetic resonance imaging (MRI) were correlated to macroscopic and microscopic pathology. Characteristic signs made recognition of hydatid disease possible, sometimes even when serologic tests had been non-conclusive. Assessment of other cysts throughout the body with or without involvement of neighbouring organs or tissues allowed appropriate therapeutic management. CT and MRI also played a key role in recognizing complications (e.g., rupture, infection of cysts).

Posterior mediastinal paravertebral hydatid cyst presenting as spinal compression: A case report

A primary posterior mediastinal hydatic cyst presenting with spinal compression syndrome is rare. We describe the case of a 35-year-old lady with a posterior mediastinal hydatid cyst who presented with progressive paraplegia. Excision of cyst was followed by systemic Albendazole therapy. She showed neurological recovery without recurrence Till now. The role of Albendazole in preventing recurrence has been stressed and the relevant literature has been reviewed.

Intrathoracic Hydatid Disease

Hydatid disease is endemic in India. From 1952 through 1965 45 patients with intrathoracic hydatid disease have been operated at this hospital. No case of mediastinal hydatid cyst was seen. There were three cases who had hepatic or subdiaphragmatic hydatid disease which ruptured into the pleura. Twelve of the cases had multiple cysts. The clinical and radiologic features are described and illustrated. Bronchoscopy and endotracheal suction should not be done in patients who have unruptured hydatid cysts. The treatment of choice for all intrathoracic hydatid cysts is surgical removal. The technique in all simple cysts and in many complicated cysts is enucleation, closing the pericyst layer with lung suture as in other segmental resections. Occasionally segmentectomy or lobectomy is required if there has been chronic spillage and infection. The mortality rate was 2 per cent. Long term morbidity occurred in the patients who had empyema or abdominothoracic disease caused by ruptured cysts. One case developed broncho-pleurocutaneous fistula. One case later had lobectomy for bronchiectasis. All other cases had excellent results with quick recovery and without recurrence.

Primary mediastinal echinococcosis

The clinical and pathologic features of mediastinal echinococcosis are discussed in the light of six cases herein presented and a review of seventy-four cases reported in the literature. In our patients a mediastinal location occurred in 6 per cent of echinococcosis in all sites. The frequency of subpleural-mediastinal location and the role of the subpleural plexus in the pathogenesis of mediastinal echinococcosis is emphasized. Mediastinal hydatid cysts are usually multivesicular, except for those in the middle mediastinum. Fifty-five per cent of all cases of mediastinal hydatid cysts were located in the posterior mediastinum. Erosion of the ribs and vertebrae and compression of the spinal cord occurred in 57 per cent of all posteromediastinal hydatid cysts. In 36 per cent of cases the mediastinal echinococcosis was located in the anterior mediastinum; compression of trachea with severe dyspnea or strangulation was the major complication. In echinococcosis of the middle mediastinum (9 per cent of all cases), compression and erosion of the great vessels is the main danger. Briefly summarized is the differential diagnosis of mediastinal echinococcosis from other mediastinal cysts and tumors, as well as from mediastinal ossifluent hydatid abscess arising from vertebral echinococcosis, from cardiopericardial hydatid disease and from paramediastinal echinococcosis. Various approaches in the surgical treatment of mediastinal echinococcosis are discussed.

A new method of determining the sensitivity of M. tuberculosis to chemotherapeutic agents.

Introduction: Pulmonary hydatid cyst is a parasitic disease caused by contamination of patients by the larval form of Echinococcus granulosus. The lung is the preferential localization after the liver. Material and Methods:A retrospective study of 40 cases of hydatid cysts of the lung treated between 2011 and 2013. Purpose:To establish the epidemiological, clinical and therapeutic findings of hydatid cysts. Results:26men and 14 women were included. The average age was 36 years [13-80 years]. Rural origin was noted in 73% of cases. Hydatid contagion was noted in 80% of cases.A history of hepatic hydatid cyst was found in 10% of cases. The clinical signs were dominated by chest pain (60%of cases), hemoptysis (35%of cases), cough (30%of cases), fever (25%of cases) and hydatid vomica (20% cases). Radiological findings showed: homogeneous round opacity (60% of cases), opacity overcome by gaseous crescent (20%of cases), hydroaeric image (15%of cases), and balloon release (5%of cases). The right sidewas achievedin 50% of cases. The lesions werebilateralin 20% of cases. CT scan performed in 18 cases showed a healthy cyst (50% of cases), a complicated cyst (35%) and rupturedintothe pleura in 10% of cases.Endoscopy done in 8 patients showed hydatid membranes in 40% of cases. Hydatidserology waspositivein80% of cases.Pulmonary hydatid cyst was isolated in 34 cases, associated with a liver cyst in 4 cases and mediastinal hydatid cyst in 2 cases. Surgery was indicated in all patients. Two patients received also medical treatment with albendazole for multiple hydatid disease. The evolution was good. Conclusion:Pulmonary hydatid disease is still common in our climate.Treatment is often surgical. Prevention is essential especially in endemic areas.