Simultaneous hydatid cysts of both the right atrium and right ventricle

Hydatid disease in both chambers of the heart is very rare. Mobile right atrial and right ventricular hydatid cysts were diagnosed incidentally in the etiologic work up for a transient ischemic attack in a 77-year-old man with a history of a hepatic hydatid cyst operation. Transthoracic echocardiography was very successful in the diagnosis of both hydatid cysts. Transesophagial echocardiography and computed tomography confirmed the diagnosis. Both right atrial and right ventricular hydatid cysts were removed under cardiopulmonary bypass to prevent morbidities and potentially fatal complications.     

Prevesical hydatid cyst: an exceptional occurrence

Echinococcal cysts usually involve the liver; extrahepatic localization is reported in 11% of all cases of abdominal hydatid disease. We report a case of a prevesical hydatid cyst. A 53-year-old man was admitted with a large suprapubic mass. Ultrasonography and computed tomography revealed a cystic mass situated in front of the urinary bladder. There were no cysts in any other location. Serological tests were positive for Echinococcus. The patient was operated on and the cyst was completely excised. The pathologic examination confirmed the diagnosis of Echinococcosis. Isolated hydatid cyst situated in front of the urinary bladder has never been described in the literature. Hydatid cyst should always be considered in the differential diagnosis of abdominopelvic masses in endemic regions, before any procedure like puncture, biopsy or cystectomy, in order to avoid dissemination of the cystic contents or an anaphylactic shock.     

Intramedullary hydatid cyst of the cervical spine

Hydatid disease (Echinococcosis) is a common parasitic infection caused by Echinococcus granulosus mainly in sheep-raising areas of the world. Liver, lungs and brain are the predominantly involved organs. However, 0.5–1% of the hydatid disease involves the spine and in 90% of the cases it is confined to the bone and the epidural space. Although intramedullary involvement is extremely rare, in this report, we present a 55-year-old female patient who was diagnosed with a cervical intramedullary hydatid cyst during magnetic resonance imaging of the cervical vertebrae. Accordingly, we imply that particularly in endemic areas, hydatid cyst disease should be kept in mind for the differential diagnosis of spinal mass lesions.     

Intraoperative diagnosis of hydatid cyst of the ovary masquerading as tumor

Hydatid disease, caused by the larval stage of Echinococcus granulosus, is found most commonly in the liver and lungs, but no organ is immune. The ovarian involvement is often secondary to a cyst's dissemination localized in a different site. Occasionally, the cyst enlarges, thus mimicking an ovarian tumor. Patients with hydatid cysts at unusual locations present with atypical presentations and pose a diagnostic dilemma. A high index of suspicion is required in order to make a correct diagnosis pre‐operatively to prevent spillage of the cyst contents during surgery. We report a case of hydatid cyst in the ovary in a young female. Diagn. Cytopathol. 2017;45:267–269. © 2016 Wiley Periodicals, Inc.     

Kyste hydatique primitif de la glande surrénale chez une patiente porteuse de situs inversus. À propos d’une observation

Primary hydatid cyst of the adrenal gland remains an exceptional localization. The adrenal gland is an uncommon site even in our country in which echinococcal disease is endemic. We report the case of a 38-year-old woman who consulted for left back pain. The CT scan showed a cystic mass in the left retroperitoneal area with a calcified wall. The patient underwent surgery which confirmed a diagnosis of hydatid cyst of the left adrenal gland. The surgical treatment consisted on a total resection of the cyst, without rupture of the cystic wall and preserving the gland. The diagnosis was confirmed on macroscopic and histological examination of the resected piece. The postoperative course was uneventful. No recurrence had occurred after 36 months of follow-up.     

Role of fine-needle biopsy in the diagnosis of hydatid cyst

The cytopathologic findings in 17 patients with hydatid cyst are reported. All patients but one were referred for evaluation of a tumor mass. In 13 patients the aspirated material was diagnostic of hydatid cyst. In four patients only acellular laminated membranes were present in the aspirate and a presumptive cytopathologic diagnosis of hydatid cyst was made. Subsequent histologic studies confirmed the diagnosis of hydatidosis in all patients. No complications were encountered. Fine-needle biopsy appears a safe diagnostic approach in the evaluation of suspected hydatid disease. The presence of acellular laminated membranes confirm the diagnosis of hydatid cyst. © 1995 Wiley-Liss, Inc.     

Multiple hydatid cystectomy of the heart necessitating LIMA to LAD anastomosis in a young patient

Cardiac hydatid disease is very rare, even in endemic regions. Clinical manifestations included chest pain, anaphylactic shock, constrictive pericarditis, congestive heart failure, and arterial embolism. Surgery is the exclusive therapy, where the cysts are excised during open-heart surgery. The surgical approach therefore must be performed carefully, given the potential complications that surgery may bring. Because of the risk of potentially lethal complications, early diagnosis and definitive treatment are important. A 32-year-old male patient was admitted with chest pain, weight loss, lethargy, and dizziness. On the transesophageal echocardiography study, a cystic mass (2.5×3×4.5 cm in dimension adjacent to the left ventricular posterior wall) that was divided into two by a septum was noted. Diagnosis of hydatidosis was confirmed with serologic tests (ELISA and indirect immunofluorescence). Echinococcosis, also known as hydatid disease, is common in several regions of the world, for example, the Mediterranean countries, the Middle East, South America, and East Africa.While performing pericystectomy in the anterior left ventricular wall, we noticed that there were three cysts, contrary to the preoperative diagnosis pointing a single one, and it was impossible to effectively complete the procedure without compromising anterosuperiorly displaced left anterior descending artery (LAD). We decided to go on bypass, arrest the heart, and complete the pericystectomy at the cost of injuring LAD and grafting the left internal mammary artery to LAD. Microscopic examination of the cyst showed a germinal layer and an avascular, eosinophilic, chitinous layer that confirmed the diagnosis of hydatid cyst. The patient was discharged on the fifth postoperative day on albendazole medication.     

Primary hydatid cyst of the adrenal gland: a case report and review of the literature

Hydatid cyst of adrenal gland is rare and usually incidentally found as a part of disseminated disease. Herein we report a rare case of primary adrenal hydatid cyst who presented with unusual symptom of arterial hypertension from an endemic country.     

Les complications pariétales du kyste hydatique du foie. à propos de deux cas en Tunisie

The aim of this study is to consider the parietal complications of the hydatid cyst of the liver: the subcutaneous rupture of the cyst and spontaneous cutaneous fistula of liver hydatid cyst. 1^st case: A 24-year-old woman, who underwent surgery 10 years ago for hydatid cyst of the liver, was admitted for a right hypochondrium mass and a fistula draining clear liquid containing cystic elements. Computed tomography (CT) showed a large cystic lesion in the subcutaneous tissue communicating with another cystic mass in the liver. The diagnosis of a cyst-cutaneous fistula due to a peritoneal hydatid cyst was established. The patient underwent surgical treatment and recovered uneventfully. 2^nd case: A 40-year-old woman presented with a mass in her right hypochondrium. The diagnosis of subcutaneous rupture of a hydatid cyst of liver was established by ultrasonography and CT-scan. The patient underwent surgical treatment and recovered uneventfully. Parietal complications of hydatid cyst of the liver are extremely rare, clinical presentation can be derailing. The diagnosis is usually established by ultrasonography and CT-scan.     

Serodiagnosis of sheep hydatidosis with hydatid fluid, protoscolex, and whole body of Echinococcus granulosus antigens

Diagnosis of hydatidosis is based on immunodiagnostic methods along with radiological and ultrasound examinations. A great number of immunological assays have been developed for detection of anti-hydatid cyst antibodies. The principal intermediate host of Echinococcus granulosus in most endemic regions of the world is sheep. Antibodies to various antigens are detectable in the sera of some, but not all infected sheep. The objective of the present study was to develop a specific and simple antigen-based ELISA method for diagnosis of hydatidosis in sheep with different (hydatid fluid, protoscolices, and whole body of E. granulosus) antigens. A total of 100 sera were collected from sheep with hydatidosis proven by inspection of hydatid-infested livers and lungs of the sheep slaughtered in Mashhad abattoir. Hydatid fluid and protoscolex were isolated from livers or lungs of sheep with hydatid cyst in sterile conditions. Whole body of E. granulosus was isolated from intestine of infected dogs. Sera samples were examined by ELISA with different antigens. The results of antibody detection by indirect ELISA, using different antigens, showed that the hydatid fluid was the most effective antigen of those assessed for detection of infection with hydatidosis in sheep. Findings of this study indicated that antibody detection assay is a sensitive approach for diagnosis of hydatid cyst in sheep.     

First Successful Puncture, Aspiration, Injection, and Re-Aspiration of Hydatid Cyst in the Liver Presenting with Anaphylactic Shock in Korea

Hydatid disease is a parasitic infestation caused by the larval form of Echinocococcus. In human, the most commonly affected organs are liver and lung. Most cysts remain clinically silent and are diagnosed incidentally or when complications occur. In Korea, hydatid disease is rare and surgically treated cases have been reported in the Korean literature. However, it is expected to confront this disease sooner or later, because of recent increase in traveling to the endemic area and industrial workers originating from those areas. With this trend, we experienced a case of hydatid cyst of the liver in a male patient from Uzbekistan. This patient was presented with anaphylactic shock combined with hydatid cyst. We successfully treated using ultrasound-guided transhepatic percutaneous drainage [termed puncture, aspiration, injection, and re-aspiration (PAIR)] of the hydatid cyst and concomitant albendazole instead of surgery. In this clinical case report, we describe all the course of the patient and recommend the PAIR as a first choice method for treatment of hepatic hydatid cyst.     

Comparative study of cattle, sheep and goats on biochemical profiles of hydatid cyst fluid from the lungs and liver

Hydatid cysts are one of the most prevalent zoonotic diseases and cause major economic and health problems around the world. The aim of this study was to evaluate and compare the biochemical profiles of hydatid cyst fluid obtained from the lungs and liver of cattle, sheep and goats naturally infected with Echinococcus granulosus. In each species, 11 biochemical profiles of hydatid cyst fluid (calcium, sodium, potassium, magnesium, glucose, urea, uric acid, cholesterol, triglyceride, creatinine and total protein) were determined and compared between the lung and the liver. No significant differences in biochemical profiles were observed in cattle, sheep or goats (P?>?0.05) indicating that biochemical profiles of hydatid cyst fluids do not relate to cyst location.     

Hydatid cyst of parotid: Report of unusual cytological findings extending the cytomorphological spectrum

Hydatid disease is a zoonotic infestation caused by larval cestode of genus Echinococcus. Cystic form of this infection mostly involves liver and lung. Hydatid disease of the parotid gland is very rare even in endemic areas and is often clinically mistaken for parotid tumors or cysts. The presence of protoscolices, laminated membranes, and isolated hooklets are characteristic cytological features observed on fine‐needle aspirate from hydatid cysts. We report unusual cytological features from a hydatid cyst of parotid in a 13‐year‐old girl. She presented with a slowly enlarging hard mass in left parotid. Fine‐needle aspiration yielded slightly turbid fluid. Smears from the sediment revealed naked parasitic micronuclei, fragments of germinative layer (endocyst), and abortive brood capsules (buds from endocyst) seen as spherical structures with multiple parasitic nuclei. Some of these spherical structures were degenerated with recognizable nuclei and others were completely necrotic. Diagn. Cytopathol. 2016;44:770–773. © 2016 Wiley Periodicals, Inc.     

Aspergillus colonization of an echinococcal cyst cavity: case report

Although lungs are common sites for the occurrence of saprophytic or invasive mycosis as well as hydatid cyst, aspergilloma within a hydatid cyst is a rare occurrence. A 36-year-old immunocompetent male presented with hemoptysis episodes of about 1 year duration. Chest X-ray revealed a smooth countered mass lesion located in the upper part of lower lobe of left lung. Surgical enucleation of the cyst wall was performed. Microscopic examination showed that the laminated membranes of hydatid cyst were invaded by septated fungal hyphea oriented with acute angles consistent with aspergillus. Herein, we report such a unique coexistence of hydatid cyst and aspergilloma, and emphasize possible complications depending on the immunostatus of the patient, if the aspergillus colonization is unnoticed in resected cystectomy material.     

Cystic echinococcosis of the heart and brain: a case report

A very rare case of echinococcus cysts of the heart and brain in a 27-year-old man who worked as a butcher, lived on a farm, and had a dog before disease onset. The initial manifestation of hydatid disease was anaphylactic shock, the etiology of which remained unknown on initial hospitalization. On rehospitalization, the diagnosis of cardiac hydatidosis was made and the patient underwent surgery. Two years later, reoperation was required for hydatid cyst of the brain and cardiac cyst recurrence. There was no other organ involvement from the disease onset, which is rarely reported. Based on this case, we suggest that echocardiography be performed as a standard method in the diagnosis of anaphylactic reaction of obscure etiology in the areas endemic for hydatidosis, even in the absence of symptoms indicative of cardiac involvement. This especially applies to individuals with occupational or epidemiological exposure to the infection.     

A Giant Pulmonary Hydatid Cyst Treated without Lobectomy

A 20 year-old woman was admitted to our clinic complaining of dyspnea, cough, chest pain and pleural effusion. The diagnosis of pulmonary hydatid cyst was made on the basis of parasitology laboratory findings, computed tomographic results and chest radiographic findings. A giant pulmonary hydatid cyst (33×14×12 cm) was located in the left lower lobe, which involved more than 90% of the lobe. The patient was treated surgically using cystotomy and capitonnage. This is a case of a giant pulmonary hydatid cyst published in the literature, which was surgically treated without a lobectomy, by preserving the lung parenchyma.     

Adrenal epithelial cyst: a case report

Epithelial-lined or true cysts of the adrenal gland are exceedingly rare accounting for only 9% of all adrenal cysts. A 55-year-old woman with a medical history for cholecystectomy and liver hydatidosis presented with an 8-month history of abdominal pain in the upper left quadrant. Physical examination was unremarkable and laboratory tests were within normal range. Computed tomography displayed a homogeneous and finely calcified cystic mass of the left adrenal gland measuring 12 x 10 cm. A hydatid cyst of the adrenal gland was suspected preoperatively and the patient underwent uneventful excision of the cyst. Histological examination of the surgical specimen revealed that the cyst wall was lined by cuboidal to flattened cells with bland cytologic features. Immuohistochemically, the cyst lining expressed intensely cytokeratin but was negative for CD 34 and calretinin. The final pathological diagnosis was epithelial adrenal cyst.     

Kyste hydatique primitif et isolé du diaphragme en Tunisie

The hydatid cyst of the diaphragm is defined as the development of a hydatid cyst in the diaphragm muscle. The purpose of this study is to identify the specific pathogenic, clinical and therapeutic aspects of this hydatid cyst. It is important to confirm the diagnosis of the location before surgery. We report the case of a patient aged 40 years, in whom the diagnosis of hydatid cyst of the diaphragm was made incidentally in the course of a gastric stromal tumour. The patient was operated by a midline laparotomy. Resection of the protruding dome of hydatid cyst of the diaphragm was carried out along with total gastrectomy. The postoperative course was uneventful. After 12 months, the results were negative. The diagnosis of hydatid cyst of the diaphragm is based on the thoraco-abdominal CT scan. The treatment is surgical based on the topographic features of the cyst.     

Severe eosinophilic cholangitis with parenchymal destruction of the left hepatic lobe due to hydatid disease

Hydatid cysts of the liver are known to occasionally rupture into the bile ducts and cause cholangitis. The histological features of this complication have not been adequately described in the literature. Herein is reported a case of severe eosinophilic cholangitis of the left hepatic lobe, occurring in a 24-year-old man with a large (16 cm) hydatid cyst, which obstructed and eroded the left hepatic duct. The patient presented with upper abdominal discomfort and low-grade fever of 3 weeks' duration. Sections of the left lobectomy specimen showed marked inflammatory infiltrates in the portal tracts, predominantly composed of eosinophils, extensively involving bile ducts of all sizes. Occasional small bile ducts were replaced by epithelioid cell granulomas surrounding eosinophilic microabscesses. The inflammatory infiltrates extended into the lobules, resulting in marked hepatocyte loss. This case demonstrates that echinococcosis may cause severe eosinophilic cholangitis with extensive parenchymal destruction, apparently resulting from a hypersensitivity reaction to parasitic antigens.     

Primary hydatidosis of gluteus maximus

Hydatid disease is a parasitic infestation of humans and herbivorous animals, caused by echinococcus granulosus. Dogs and some wild carnivores, like foxes, are definitive hosts, harboring worms in their intestines. Eggs are passed in feces and eaten by intermediate hosts and larvae encyst in the liver, lungs and other organs. Primary muscular hydatidosis without involving the thoracic or abdominal organs is extremely rare. A case of intramuscular gluteal hydatid cyst is being reported with the intent of highlighting this atypical localization of the disease. Since the soft tissue tumors may be confused with hydatid cysts, preoperative evaluation of these patients is critical for proper handling during surgery to avoid life-threatening complications. We report a case of a 24-year-old male patient with a cystic gluteal swelling turning out to be hydatid cyst on sonography and computerized scanning. Surgical excision with postoperative antihelmenthics formed the main modality of treatment.