Primary Giant Mediastinal Hydatid Cyst Extending to the Superior Thoracic InletA 57-year-old woman presented to our hospital with chest and shoulder pain. A giant mediastinal cystic lesion extending from the apex to the inferior perihilar area on the right hemithorax was detected radiologically. The patient underwent video-assisted thoracoscopic surgery. The intraoperative lesion was identified as a hydatid cyst and resected thoracoscopically (Figure 1).
(A) Axial, (B, C) coronal, and (D) sagittal thoracic computed tomography sections show a mediastinal cystic lesion of approximately 10 x 4 cm (arrowheads) extending from the apex to the perihilar area in the right hemithorax. (E, F) The lesion was diagnosed intraoperatively as a hydatid cyst (arrow, laminated membrane; circle, cyst cavity).
Hydatid cysts caused by metacestode forms of Echinococcus granulosus are commonly located in the liver and lungs. The mediastinal involvement rate is 0.61%, and primary mediastinal localization is less common1. Symptoms depend on the cyst size, location, and compression on adjacent structures, such as the esophagus, aorta, trachea, vena cava, and phrenic nerve2,3. Although primary giant mediastinal hydatid cysts are rare, they should be considered in the differential diagnosis of all mediastinal lesions.
REFERENCES
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1 Aydin Y, Ulas AB, Ince I, Korkut E, Ogul H, Eren S, et al. Large Case Series Analysis of Cystic Echinococcosis. Indian J Surg (2021). https://doi.org/10.1007/s12262-021-03061-0.
» https://doi.org/10.1007/s12262-021-03061-0 - 2 Aydin Y, Gursan N, Turkyilmaz A, Eroglu A. Mediastinal calcified hydatid cyst. Ann Thorac Surg. 2011;92(4):e85.
- 3 Aydin Y, Ogul H, Turkyilmaz A, Eroglu A. Surgical treatment of mediastinal cysts: report on 29 cases. Acta Chir Belg. 2012;112(4):281-6.
