A Posterior Mediastinal Hydatid Cyst

Abstract

Hydatid disease is endemic in Turkey. Although the most common placement of this disease is in the liver and lungs in the form of a hydatid cyst, it can present in atypical localizations. Mediastinal hydatid cysts are extremely rare. To the best of our knowledge, there has been no case reported of a mediastinal hydatid cyst in a human immunodeficiency virus (HIV)-positive patient. Herein, we present to a case with a mediastinal cyst who was successfully treated with cystectomy.

A Primary Posterior Mediastinal Hydatid Cyst Manifesting as Acute Coronary Syndrome

“…The presence of peripheral calcifications supports diagnosis. A predilection for the posterior compartment of the mediastinum has been reported in the literature [8,11].…”

“…On entering the intestines of humans, the parasite gains further entry to locate itself in the liver or lung, and its passage into the systemic circulation is responsible for its location in diverse locations [5,7]. These two organs are a blood filter for the dissemination of the parasite, thus explaining the rarity of hydatid in all other locations [5,8]. Unlike the very frequent pulmonary parenchymal localizations in the endemic area, in particular in children [9,10], the primary mediastinal localization of hydatid cyst is among the rarest.…”

“…Hydatic cyst of the mediastinum is often revealed by chest pain and signs of mediastinal compression, these symptoms vary according to the size of the lesions, the growth rate, and the location. In a study including 27 cases with mediastinal masses, 49% had chest pain, 37% had dyspnea, 11% had a cough, and 3% had superior vena cava syndrome [8,14]. In addition to compression symptoms experienced by patients with mediastinal hydatid cysts, there may also be discovered by a complication as an embolism or anaphylaxis due to the rupture of the cyst in the bronchi or vessels; spread or infection of the ruptured cyst; cord compression due to intraspinal spread; and costal, vertebral, and chest wall erosions [1,5,6].…”

“…Thoracic ultrasound also reveals the fluid character of the opacity and, in many cases, the proligerous membrane, pathognomonic of HC [5,9], it also clarifies the univesicular or multivesicular structure characteristic of HC The thoracic. In the majority of cases, a chest CT can confirm the diagnosis by objectifying a mass of fluid density, often very limited, unmodified by the injection of contrast, however, contrast uptake by a pericyst can be observed [8,9]. The cyst may also include thin walls testifying to its multivesicular character.…”

“…These different ways of cross-sectional imaging (ultrasound, CT, MRI) allow, in most cases, mediastinal hydatid cystic masses to be differentiated from other mediastinal cystic masses, such as enteric cyst, cystic lymphangioma, pleuropericardial cyst and bronchogenic cyst. Although these tests may lead to an accurate diagnosis, this is rather atypical for mediastinum located hydatid cysts, and the diagnosis is usually made postoperatively [8]. Hydatid serology is the only biologic aid to preoperative diagnosis.…”