Primary mediastinal hydatid cysts

Abstract

Hydatid cysts are a parasitic disease caused by Echinococcus granulosus, and 0.5 to 2.6% of all hydatid cysts are in the mediastinum. In this study, we presented primary mediastinal hydatid cysts. All patients underwent chest X-ray and thoracic computed tomography (CT), and only one patient underwent thoracic magnetic resonance imaging (MRI) due to the association with spinal cord. All lesions removed through thoracotomy were confirmed pathologically, and no postoperative complications were observed, except for one patient. Anthelmintic treatment was started in one patient with vertebral involvement. No recurrence was observed in any of the patients. Although mediastinal hydatid cysts are rarely encountered, it is difficult to differentiate mediastinal hydatid cysts from other mediastinal diseases. However, the diagnosis is often made intraoperatively. Despite being a benign disease, mediastinal hydatid cysts should be removed surgically, as they may lead to serious complications due to deformation.

Keywords

• Mediastinum
• hydatid cyst
• echinococcosis
• ekstrapulmonary

Primer mediastinal kist hidatikler

Öz

Hidatik kist, Echinococcus granulosus'un neden olduğu paraziter bir hastalıktır. Tüm kist hidatik vakalarının %0.5-2.6'sı mediastinal yerleşimlidir. Çalışmamızda primer mediastinal kist hidatikleri sunduk. Bütün hastalarda akciğer grafisi, toraks bilgisayarlı tomografi (BT) çekildi. Bir olguda spinal kordla ilişkisi nedeniyle toraks manyetik rezonans görüntüleme (MR) çekildi. Torakotomi ile çıkarılan bütün lezyonlar patolojik olarak doğrulandı. Postoperatif bir hastada dışında komplikasyon gelişmedi. Vertebra tutulumu olan bir olguda antihelmitik tedavi başlandı. Hiçbir olguda nüks gözlenmedi. Mediastinal kist hidatikler nadir görülmekle beraber diğer mediastinal hastalıklardan ayrımı zordur. Çoğu zaman cerrahi sırasında tanı konulur. Benign bir hastalık olmasına rağmen dektrüksiyona yol açarak ciddi komplikasyonlara neden olabileceğinden cerrahi olarak çıkarılmalıdır.

Anahtar Kelimeler

• Mediastinum
• hydatid cyst
• ekinokokkoz
• ektrapulmoner

References

1. 1. Emlik D, Kiresi D, Sunam GS, Kivrak AS, Ceran S, Odev K. Intrathoracic Extrapulmonary Hydatid Disease: Radiologic Manifestations. Canadian Association of Radiologists Journal. 2010;61(3):170-6.
2. 2. Traibi A, Atoini F, Zidane A, Arsalane A, Kabiri el H. Mediastinal hydatid cyst. J Chin Med Assoc. 2010;73(1):3-7.
3. 3. Mohammadi A, Khodabakhsh M. Multiple mediastinal hydatic cyst: a case report. Tuberk Toraks. 2011;59(1):70-2.
4. 4. Rakower J, Milwidsky H.: Primary mediastinal echinococcosis. Am. J. Med. 1960;29:73-83
5. 5. Eroğlu A, Kürkçüoğlu C, Karaoğlanoğlu N, Tekinbaş C, Kaynar H, Önbaş Ö. Primary hydatid cysts of the mediastinum. European Journal of Cardio-Thoracic Surgery.2002;22(4):599-601.
6. 6. Sevinc S, Samancılar O, Ozturk T, Unsal S, Kaya SO. Fistulization of hydatid mediastinal cyst to the anterior thoracic wall: case report. Kardiochir Torakochirurgia Pol. 2014;11(4):425-7. doi: 10.5114/kitp.2014.47345.
7. 7. Kamyar MM, Ravari H. Thoracic aortic involvement in cystic echinococcosis: A case report. Electron Physician. 2017:25;9(9):5257-60. doi: 10.19082/5257.
8. 8. Kumar S, Satija B, Mittal MK, Thukral BB. Unusual mediastinal dumbbell tumor mimicking an aggressive malignancy. J Clin Imaging Sci. 2012;2:67. doi: 10.4103/2156-7514.103057.

9. 9. Gopivallabha MM, Singh AK, Pasarad AK, Parashuraman P, Govindareddy AK. Primary mediastinal hydatid cyst causing diaphragmatic palsy. Braz J Cardiovasc Surg. 2020;35(1):123-6
10. 10. Torre W, Tamura A, Querejeta E, Pila U. Video-assisted resection of a mediastinal hydatid cyst. An Sist Sanit Navar. 2011;34(3):481-3.