A rare presentation of cystic echinococcosis: aortic involvement

Abstract

Cystic echinococcosis is an endemic parasitic infestation caused by the larval stage of Echinococcus granulosus. Although infestation of any part of human body can occur, isolated cardiac involvement is uncommon. We present a case of isolated hydatidosis involving the ascending aorta.

Multiple recurrent cystic echinococcosis with abdominal aortic involvement: A case report

“…In this report, the patient had recurrent CE in the abdomen/retroperitoneum with aortic invasion after resection of splenic CE, which according to previous publications is even rarer[ 7 , 8 ]. Moreover, this patient suffered a severe intraoperative aortic rupture.…”

“…Aortic or cardiovascular involvement are reported case by case[ 7 , 9 , 10 ]. There are several life-threatening complications in patients with aortic disease, such as anaphylactic shock, false aneurysm, systemic emboli and arterial occlusion[ 8 ]. Tosya et al[ 8 ] showed that an embolism of the germinative membranes was caused by ruptured cardiac hydatid cysts or by cystic lesions in the ascending aorta, and recommended using DSA, ultrasound, computed tomography and magnetic resonance imaging to accurately detect the relationship between the cyst and aorta, and excision of the capsule wall and graft implantation should be the first treatment choice.…”

Hydatid cyst of the middle mediastinum complicated by fistulated ascending aorta: A case report and review of the literature

“…Previous studies recommended that digital subtraction angiography, CT scan, MRI, and ultrasound as effective approaches for detecting the exact relation of cysts and aorta walls in thoracic and aortic hydatid cysts. 10 However, in our case, a CT scan showed a mass located in aortopulmonary window, and the involvement of the aorta was not considered preoperatively. In rare cases, as in ours, the diagnosis of hydatid cysts in uncommon locations may only be confirmed during surgery by visualizing daughter cysts or through pathological examination.…”

“…Preoperative diagnosis of extrahepatic and pulmonary hydatid cysts is challenging, even in endemic areas, unless there is a specific consideration for a hydatid cyst. Previous studies recommended that digital subtraction angiography, CT scan, MRI, and ultrasound as effective approaches for detecting the exact relation of cysts and aorta walls in thoracic and aortic hydatid cysts 10 . However, in our case, a CT scan showed a mass located in aortopulmonary window, and the involvement of the aorta was not considered preoperatively.…”

Thoracic aortic involvement in cystic echinococcosis: A case report

“…The aortic wall may also be involved secondary to invasion of the cyst from adjacent tissues (7, 8) similar to that which we had encountered. Aortic involvement may display as pseudoaneurysm (7–9), organ ischemia due to aortic occlusion (5, 6), remote ischemia due to daughter cysts embolization (10, 11, 12), simple cystic mass (3), or even aortobronchial fistula (12). Treatment in all patients with aortic involvement consists of surgical resection of the cyst and its content, and long-term medical therapy.…”