SESSION TITLE: Infections Global Case Reports
SESSION TYPE: Global Case Report Poster
PRESENTED ON: Tuesday, October 27, 2015 at 01:30 PM - 02:30 PM
INTRODUCTION: Hydatid cystic disease is still endemic in North Africa, usually located in the liver and lung. Mediastinal hydatid disease remains very rare.
CASE PRESENTATION: We report here a case of a 40-year-old woman initially presented with hemoptysis and cough. The chest x-ray showed a large opacity of the mediastinum. CT scan showed a huge hydatid cyst of lung with multiple and multilocular mediastinal hydatic cysts arranged in a distinctive "bunch of grapes" pattern. Performed biological tests showed no abnormality except positive hydatic serology. Abdominal and pelvic ultrasound showed no liver or other hydatid cysts. Spirometry showed severe airflow obstruction (FEV1 25%, FVC 90%, FEV1 /FVC 24%). Patient was sent for surgical excision of both lung and mediastinal hydatid cysts.
DISCUSSION: Hydatid disease is endemic in many parts of the world. Only few cases of multiple mediastinal hydatid cysts were reported in literature, it is rare to find it in the mediastinum; less than 0.1% of all hydatid disease cases Radiologic and serologic findings can generally help establish the diagnosis especially in patients living in endemic region. To the best of our knowledge, a case with multiple multilocular mediastinal hydatic associated with lung hydatid cyst is not reported already. In our case multiple mediastinal hydatid cysts were compressive with severe airflow obstruction. Surgery incision remains the best treatment choice.
CONCLUSIONS: Associated hydatid cysts of the mediastinum and lung are uncommon but they should be included in the differential diagnosis of the mediastinal cyst in endemic countries. Echinococcus granulosus can produce cysts in almost every organ of the body at the same time.
Reference #1: Hydatid disease from head to toe. Polat P1, Kantarci M, Alper F, Suma S, Koruyucu MB, Okur A. Radiographics. 2003 Mar-Apr;23(2):475-94; quiz 536-7.
Reference #2: Multiple mediastinal hydatic cyst: a case report. Mohammadi A1, Khodabakhsh M. Tuberk Toraks. 2011;59(1):70-2.
DISCLOSURE: The following authors have nothing to disclose: Tarek Djenfi, Redha Selmani, Abdelmadjid DJEBBAR
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