Primary hydatid cysts of the mediastinum

Abstract

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.

Primary Mediastinal Hydatid Cysts

“…And also, hydatid disease is endemic in certain parts of Turkey. Traibi 9) and Eroglu 10) found high mediastinal involvement rates as their patients were living in the endemic regions.…”

Video-Assisted Thoracoscopic Surgery of Mediastinal Cysts: Report of 13 Cases

“…Mediastinal hydatid cysts form only 0.5 to 1 % of all hydatid cysts [8]. If total excision of the cyst is not possible due to cyst localisation or invasion of vital organs, a hydatid cyst can be managed by partial pericystectomy after excision of the germinative membrane.…”

Hydatid cyst of mediastinum

“…[6] Primary hydatid cyst of the mediastinum, although extremely rare, is a distinct clinical entity, which must be considered in a patient with mediastinal mass in endemic regions. [7] In general, mediastinal echinococcosis is neither clinically nor radiologically distinguishable from other mediastinal cystic lesions. [8] Diagnosis can be reached after the combined assessment of clinical, radiological, historical and laboratory data of patients, as in the case presented here.…”