Giant pulmonary hydatid cyst causing a mediastinal shift in a child

A 9-year-old girl presented with a cough and dyspnea. Thoracic computed tomography (CT) detected a giant cystic lesion and mediastinal shift (Figure 1). The patient underwent cystotomy and capitonnage through a right thoracotomy.

FIGURE 1:
Contrast-enhanced thoracic CT coronal (A) and axial sections (B) shows a giant hydatic cyst of approximately 9 cm x 12 cm x 13 cm in the lower lobe of the right lung (arrows) and a shift to the left in the mediastinum.

Hydatid cyst disease continues to be an important public problem today. The causative agent of this disease is a parasite belonging to the cestode class, Echinococcus granulosus¹. Carnivorous animals are the parasite's definitive hosts, and the disease is transmitted via the fecal-oral route. The eggs of the tapeworm in the main host are excreted in feces. Water and food contaminated with these feces are taken up by intermediate hosts. The life cycle continues when carnivorous animals consume the cyst-containing internal organs of herbivorous intermediate hosts. Hydatid cysts grow faster in children than adults due to the elasticity of the lung^2,3. Hydatid cysts may rarely cause a mediastinal shift. Children with pulmonary hydatid cysts should be treated surgically as soon as possible.

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;83(Suppl 4):S897-S906. Available from: https://doi.org/10.1007/s12262-021-03061-0.
  » https://doi.org/10.1007/s12262-021-03061-0
• ²
  Aydin Y, Dostbil A, Araz O, Ogul H, Ulas AB, Zeytun H, et al. Pre-school children with hydatid lung disease. Acta Chir Belg. 2013;113(5):340-5.
• ³
  Aydin Y, Ulas AB, Ince I, Kalin A, Can FK, Gundogdu B, et al. Evaluation of albendazole efficiency and complications in patients with pulmonary hydatid cyst. Interact Cardiovasc Thorac Surg. 2022;34(2):245-9.

• 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
  20 Feb 2023
• Date of issue
  2023

History

• Received
  08 Dec 2022
• Accepted
  03 Jan 2023