Primary Giant Mediastinal Hydatid Cyst Extending to the Superior Thoracic Inlet

A 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).

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 nerve^2,3. Although primary giant mediastinal hydatid cysts are rare, they should be considered in the differential diagnosis of all mediastinal lesions.

REFERENCES

• 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.

• Financial Support: The authors declare that the article content was composed in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Publication Dates

• Publication in this collection
  19 Sept 2022
• Date of issue
  2022

History

• Received
  09 May 2022
• Accepted
  10 June 2022