Calcified liver hydatid cyst compressing the gall bladder

A 48-year-old male patient was admitted to suffering from hydatid disease located in the gall bladder. Although Morocco remains an endemic area for echinococcosis, this presentation of the disease was rare. The pericyst was tightly attached to the liver. Complete pericystectomy with cholecystectomy was done. Histopathology confirmed the presence of a calcified hydatid cyst of the gall bladder. Perioperative adjuvant medical therapy with albendazole was administered. After a 2-year follow-up, no recurrence occurred.     

Cholecysto-hydatid cyst fistula.

A 27-year-old woman developed recurrent hydatid of liver. CT scan showed unilocular cysts in segments IV and VII. Intraoperatively, there was a fistulous communication between the gall bladder and the cyst in segment IV. Partial pericystectomy along with cholecystectomy was done for the segment IV cyst; percutaneous aspiration, instillation and re-aspiration using hypertonic saline was done for the cyst in segment VII. This was followed by albendazole treatment.     

Recurrent multiple cardiac hydatidosis.

Cardiac hydatid cyst is an uncommon disease. We report on a woman admitted to our clinic with chest pain and palpitations. The ECG showed anterior ischemia, and coronary anatomy was normal. The diagnosis was: multiple cardiac hydatid cysts, for which she had undergone surgery 4 years earlier for a 5 x 5 hydatid cyst and treated with albendazole. Despite this, there was a recurrence of multiple cysts. Recurrence of intracavitary hydatid cyst is rare, and surgical treatment of multiple, small cysts remains controversial.     

Atypical pulmonary giant hydatid cyst as bilaterally symmetrical solitary cysts

A pulmonary giant hydatid cyst, a special clinical entity, is rare. Our case involves a young patient who presented with a bilaterally symmetrical solitary cyst in each lung, a feature consistent with congenital lung cysts. The radiological and immunological findings were equivocal. A diagnosis of giant hydatid cyst was made intraoperatively and both cysts were removed conservatively. A follow-up showed complete recovery.     

Intracavitary left ventricular hydatid cysts ruptured during cardiopulmonary resuscitation in a patient with acute myocardial infarction

Cardiac hydatid cyst is a rare complication of parasitic infection caused by Echinococcus granulosus. Cardiac involvement occurs in only 0.2-2% of hydatidosis cases. Rupture of hydatid cysts into cardiac chambers is very rare. In this report, we present a case of intracavitary left ventricular hydatid cysts ruptured during cardiopulmonary resuscitation in a patient with acute myocardial infarction.     

Lone,Mobile Left Atrial Hydatid Cyst

Echinococcosis is endemic in various regions of Turkey. Cardiac involvement in echinococcosis is rare, and lone cardiac hydatid cysts are even more unusual. Because cardiac hydatid disease can be fatal, even asymptomatic patients are optimally referred for surgical treatment. We present a rare case of a lone, primary, mobile hydatid cyst in the left atrium of a 62-year-old woman. The cyst caused dyspnea from left ventricular inflow obstruction. In addition to reporting the patient''s fatal case, we discuss cardiac hydatid cysts in terms of the scant medical literature.     

Primary splenic hydatidosis

Primary extrahepatic hydatid cysts are rare, and primary splenic hydatid cysts even more so, constituting 2% to 3.5% of all hydatid cysts. We report here a case series of isolated splenic hydatid cysts. Case records of 382 adult patients of abdominal hydatid cysts were analyzed; eight of them (2%; aged 23 to 45 years, 5 women and 3 men) had primary splenic hydatid cysts. Seven patients presented with dull dragging pain in the left hypochondrium. Four patients had splenomegaly. Diagnosis was made at ultrasonography and/or contrast-enhanced computed tomography. Enzyme linked immunosorbent assay for hydatid antibodies tested positive in all patients. One patient presented with hemoperitoneum. All patients underwent splenectomy. Primary splenic hydatid cyst is rare but should be considered in patients with cystic lesions of the spleen.     

Retroperitoneal localization of hydatid cyst disease

In this study we discuss a rare case; hydatid cyst disease that is located in the retroperitoneum. Two cases were treated in our department with hydatid cyst disease located in the retroperitoneum; one of the cysts was in the minor pelvis and the other was on the left psoas muscle. Diagnosis was confirmed with blood tests, and radiological examinations. The cyst wall was excised partially and was oversewn. Following the operation both of the patients were given albendasole tablets for 10 weeks with blood count and liver enzyme monitorization. Hydatic cysts located in retroperitoneum were treated successfully. Especially in the endemic areas hydatid cyst should be remembered when evaluating cystic masses in the retroperitoneum. It can be treated successfully with surgery.     

Asymptomatic pericardial hydatid cyst

Cardiac involvement is rare in hydatid disease, but it carries a significant risk of potentially lethal complications. Cardiac hydatid cysts are mostly intramyocardial. Pericardial hydatid cysts without myocardial involvement are much less frequent. Cardiac imaging techniques, particularly two-dimensional echocardiography, are more useful in the detection of cardiac cysts. We present an incidentally detected, asymptomatic, pericardial hydatid cyst.Presented in part at the 39th Annual World Congress, International College of Angiology, Istanbul, Turkey, July 1997.     

A splenic hydatid cyst case presented with lumbar pain

A splenic hydatid cyst is a rare clinical entity from among abdominal hydatid cysts, even in endemic countries. Here, a case with lumbar pain due to a giant splenic hydatid cyst is presented. The importance of this case is that the patient presented at the clinic with only lumbar pain. Initial direct abdominal plain radiography showed a giant abdominal calcification in the spleen and further examinations revealed involvement of three organs: spleen, lung, and liver.     

A retrospective study on the coexistence of hydatid cyst and aspergillosis.

OBJECTIVES: Hydatid cyst is a zoonotic disease with an endemic regional distribution, and Aspergillus is a saprophytic fungus that may cause allergic pulmonary aspergillosis, aspergilloma, and semi-invasive and invasive aspergillosis. The coexistence of a saprophytic fungus and hydatid cyst is extremely rare. The aim of this retrospective study was to evaluate the coexistence of aspergillosis and echinococcosis in archival materials and to discuss its probable clinical significance. METHODS: Hematoxylin-eosin (HE)-stained sections of 100 archival cases with the diagnosis of hydatid cyst were reevaluated by four pathologists independently. Grocott's methenamine-silver (GMS) and periodic acid-Schiff (PAS) were applied to the slides that were suspected of having co-infection with Aspergillus to confirm the diagnosis. RESULTS: Two cases of aspergillosis and hydatid cyst coexistence were found out of the 100 reevaluated archival cases with a diagnosis of hydatid cyst. Both of the cases were located in the lung, in immunocompetent patients. CONCLUSIONS: Aspergillosis and hydatid cyst coexistence may be important in patients with immune deficiency and in cases with pre- or perioperatively ruptured cysts. There are no reliable data on the specificity and sensitivity of radiological imaging techniques in detecting the existence of Aspergillus in hydatid cysts. Histopathological evaluation is essential for diagnosis and for the planning of management.     

Complications of extrahepatic echinococcosis：Fistulization of an adrenal hydatid cyst into the intestine

Echinococcal cysts are usually found in liver and lungs, but any other organ can potentially be involved. Extrahepatic disease due to hydatid cyst may develop in the abdominal and pelvic cavity, aside from in other less common locations, which may make both diagnosis and treatment more complex. We present a rare case of extrahepatic echinococcosis in a 70-year old patient with a 4-d history of dull abdominal pain, anemia within the transfusion range and fever. She underwent surgery for left renal hydatid cysts 30 years ago. After non operative treatment, imaging studies showed a calcified hydatid cyst in a retrogastric location communicating with a proximal jejunal loop. En-block resection of the mass together with the adrenal gland was performed including closure of the enteric fistula. Anatomic pathology confirmed the diagnosis of a calcified hydatid cyst of left adrenal origin. Surgery is the treatment of choice and most authors recommend removal of cyst and adrenal gland.     

Recurrent pulmonary microemboli secondary to primary cardiac hydatidosis

Primary cardiac hydatid cysts are rarely diagnosed and seldom rupture to lungs via pulmonary vein resulting in multifocal cystic lesions. We report a rare instance of an interventricular hydatid cyst. A 19-year-old patient was admitted with dyspnea and multiple homogenous opacities with different sizes in his chest X-ray and contrast enhanced thorax computed tomography. We considered recurrent pulmonary microemboli, although neither systemic embolisation nor intravascular cyst of pulmonary arteries was detected. Due to extensive distribution of the pulmonary cysts, only the cardiac cyst was taken surgically. The patient remains in our care without any pulmonary improvement despite appropriate medical treatment.     

Hydatid cyst of the interventricular septum. Contribution of magnetic resonance imaging]

Cardiac localisation of hydatid cysts is rare representing 0.5 to 2% of all clinical forms of this condition. Hydatid cysts are usually observed in the left ventricle and involvement of the interventricular septum is exceptional. The principal diagnostic and preoperative investigations are serology and imaging by echocardiography and computed tomography, which can give conflicting results. The authors report a case of hydatid cyst of the interventricular septum in which computed tomography was non-contributory whereas echocardiography (the key investigation in all cases of hydatid cyst) associated with nuclear magnetic resonance imaging provided particularly accurate preoperative information. The latter investigation also allowed diagnosis of pulmonary, hepatic, splenic and renal involvement of the disease.     

Syncope as the primary manifestation of hydatid cyst

Hydatid disease is a parasitic infestation that is caused by the larvae of the tapeworm Echinococcus granulosus. Clinical manifestations are extremely variable and related to the location and the size of the cysts. Syncope as the first clinical presentation of hydatid cyst is a very rare condition. Herein, we report two cases of patients with cardiac and pleural hydatid cysts who had syncope as the initial symptom.     

A case of asymptomatic cardiopericardial hydatid cyst

Cases with cardiac hydatid cyst disease are uncommon, being approximately 0.2-2% of all cases. Most cardiac hydatid cysts are located in the interventricular septum or left ventricular wall. Pericardial location is very rare. We report a 42-year old Turkish man with pericardial hydatid cyst disease who was otherwise asymptomatic, having no cardiac symptomatology. The most appropriate therapeutical option for a hydatid cyst is surgical removal of the cyst mass. However, our patient refused surgical treatment and thus medical treatment with albendazole was initiated. Following the first month of the drug therapy, pericardial effusion disappeared. The cystic nature of the mass disappeared and was solidified at the 6th month of treatment. The patient has been followed-up by us asymptomatically.     

A huge cardiac hydatid cyst: An unusual cause of chest pain revealing multivisceral hydatidosis in a young woman

Hydatid disease remains endemic in some parts of the world. Cardiac hydatidosis with multivisceral involvement is uncommon but potentially fatal. We report the case of a 36-year-old Tunisian woman admitted with chest pain and T-wave inversion in the inferior leads on her electrocardiogram. Transthoracic echocardiography revealed a large hydatid cyst in the epicardium throughout the left ventricle. Thoraco-abdominal computerized tomography (CT) scan showed several hydatid cysts in the left lung, the liver, and in both breasts.After one week of albendazole treatment, surgical excision of the cardiac cyst on cardiopulmonary bypass was carried out as well as excision of the pulmonary and breast cysts. The postoperative course was uneventful and albendazole treatment was continued for six months. Though hydatid cardiac involvement is very rare, it should be considered in the differential diagnosis of atypical chest pain in young patients, especially those living in regions where hydatid disease is endemic.     

Intracavitary cardiac hydatid cysts with a high risk of thromboemboli

Hydatid cysts are a serious health problem in many countries that raise farm animals, and they usually involve the liver and lungs. Although cardiac involvement is a rare manifestation of hydatid cyst disease, its early diagnosis and surgical management are crucial. Patients with cardiac hydatidosis may develop acute life-threatening complications secondary to their invasion of surrounding cardiac structures, such as cyst rupture together with systemic and pulmonary dissemination. Therefore, surgical excision is the definitive method of treatment for cardiac hydatid cysts in order to prevent these potential life-threatening complications, even for asymptomatic patients. Herein, we report the case of a 36-year-old man who initially presented with pleuritic chest pain, hemoptysis, and dyspnea. This was followed by the revelation of multiple cardiopericardial hydatid cysts which were discovered via transesophageal echocardiography and multislice computed tomography. In this case, there was a higher risk of cyst rupture and thromboembolism during systemic and pulmonary circulation due to the invasive nature of the cysts which were located in the left atrium as well as between the pulmonary artery and aorta. The patient successfully underwent the removal of the multiple cardiac cysts under cardiopulmonary bypass by taking into account their relationship with the surrounding cardiac structures and the potential risk of local, systemic, and pulmonary dissemination. A pathological evaluation of the surgical specimens confirmed the diagnosis of cardiac echinococcosis and the aggressive nature of the cardiopericardial hydatid cysts by demonstrating their myocardial invasion.     

Primary intradural extramedullary hydatid cyst

Spinal hydatid cysts account for 1% of all cases of hydatid disease; primary intradural hydatid cysts are uncommon. We present a case of pathologically confirmed intradural spinal cyst hydatid in an otherwise healthy patient who showed no other evidence of systemic hydatid cyst disease. The patient presented with back pain, paraparesis, and weakness. An intradural extramedullary cystic lesion was identified with magnetic resonance imaging and was shown to be a hydatid cyst by histopathologic examination after surgical removal. To our knowledge, this is the 25th case of hydatid cyst at an intradural extramedullary location reported in the literature.