Hepatobiliary cystadenoma with mesenchymal stroma mimicking hydatid cyst. Report of a case

We report on a case of hepatobiliary cystadenoma with mesenchymal stroma in a 44-year-old Caucasian woman who presented with upper abdominal discomfort. Ultrasound (US) and computed tomography (CT) showed a cystic mass resembling hydatid cyst. Endoscopic retrograde cholangiography (ERC) demonstrated communication with the left hepatic duct. At surgery, a cystic mass with communication to the left hepatic duct was found and resected en bloc with a margin of normal liver tissue. Histological examination showed a hepatobiliary cystadenoma with mesenchymal stroma.     

Bronchoesophageal cyst in adults. Apropos of a case]

The authors report the case of a 61-year old woman who was operated upon for a paraoesophageal cyst of the bronchogenic type. Having reviewed the French literature on the latest cases, they underline the scarcity of these congenital formations which present as mediastinal cystic tumours with benign expression and course. Computed tomography suggests the diagnosis and reveals the intraparietal site of the cyst. A return to the histogenesis of these cysts makes it possible to understand the nosological distinction with the true bronchogenic cysts and to evaluate the recent classifications.     

Multicavitated left atrial myxoma mimicking a hydatid cyst.

A 67 year-old asymptomatic patient was referred to our echo-lab because of hypertension. Transthoracic 2D-echocardiogram showed a non-prolapsing ovoid mass attached to the left side of the interatrial septum. Transesophageal echocardiography evidenced an ovoid cavitated mass with internal areas of calcification. Color Doppler revealed flow inside the cavities. At surgery, a multicavitated mass was observed attached to interatrial septum. Macroscopically revealed cavities filled with blood, as well as partially calcified areas. Microscopically there were collections of "lipidic" cells embedded in the myxoid matrix, typical of cardiac myxoma. Cardiac hydatid cysts usually have a rounded shape. Most myxomas are solid masses without a cystic architecture or cavitations. Calcification is usually identified at a microscopic level. The combination of a polycystic appearance of the mass and macroscopic areas of calcification is more frequently observed in hydatid cysts than in cardiac myxomas. This appearance of the mass leads us to consider a cardiac echinococcal cyst as the first diagnostic possibility. This peculiar structure of cardiac myxoma, to the best of our knowledge, has never been documented. Transthoracic echocardiography and particularly transesophageal imaging, enable us to delineate this kind of tumors. Surgical resection is the appropriate treatment for these tumors, even in asymptomatic patients.     

Subcutaneous extension of a large diaphragmatic hydatid cyst

INTRODUCTION Hydatid disease is a parasitosis, known as hydatidosis or echinococcosis caused by the larval stage of the Echinococcus granulosus tapeworm. The disease was first described by Hippocrates as “cysts full of water” in a man’s liver and by Ar…     

Transdiaphragmatic extension of hepatic hydatid cyst

Transdiaphragmatic extension of hydatid cyst (HC) or cystic echinococcosis (CE) of the liver is a rare phenomenon. We report a case that presented as a right middle lobe consolidation. The diagnosis of transdiaphragmatic extension of hepatic hydatid cyst was suspected on CT scan of the chest and abdomen, and confirmed operatively. A successful outcome was achieved by a combination of pre- and post-operative albendazole therapy combined with surgery.     

Staged management of a giant cardiac hydatid cyst: a case report

Background

We report on a 21-year-old patient with a giant symptomatic hydatid cyst of the interventricular septum, to whom a staged management approach was employed. Induction medical therapy led to a reduction in the size of the cyst, which was then completely removed via surgical excision.

Case presentation

A 21-year-old male Caucasian, with main complaints of fatigue and palpitations, was referred to our Centre due to a cystic formation in his left ventricle. The workup consisted of transthoracic echocardiography and cardiac magnetic resonance, which revealed a huge hydatid cyst in an active stage of disease, occupying the basal and mid part of the interventricular septum. Due to the size of the lesion and lack of viable myocardium in the affected area, the patient was declared inoperable and medical therapy was initiated. Serial echocardiography revealed a significant reduction in the size of the lesion and degradation to transitional and inactive stage, after which successful surgical excision of the cyst was performed. In the course of the medical treatment, the patient experienced sustained ventricular tachycardia causing loss of consciousness, which did not reoccur after surgical excision.

Conclusion

Medical therapy can result in the degradation of a giant heart hydatid cyst, enabling surgical excision. Heart hydatid cyst can lead to potentially lethal arrhythmia irrespective of its size and stage, which does not reoccur after successful surgical excision.

     

Right intraventricular tumors. Apropos of a case

The authors report a case of right ventricular tumour in a 16 year old girl who presented with dyspnoea on effort, chest pain on exertion and loss of consciousness. The diagnosis was made on the basis of abnormal right intraventricular echoes on two dimensional echocardiography and was confirmed by angiography. The patient was operated with success. Histology revealed a mesenchymoma, a benign tumour, but whose infiltrating nature calls for a reserved prognosis. The echocardiogram can be used for regular post-operative surveillance. The young patient is well after 18 months' follow-up.     

Right intraventricular hydatid cyst of the heart

A 32-year-old woman presented with shortness of breath and palpitations. Echocardiography and contrast-enhanced computed tomography showed a 4 x 5 cm cyst in the apex of the right ventricle. The cyst was excised on cardiopulmonary bypass. The patient made an uneventful recovery. At the one-year follow-up, she was symptom-free and without recurrence. Different clinical aspects of cardiac hydatid cyst and its surgical management are reviewed.     

Intrapericardial hydatid cyst. Report of a case successfully operated

Hydatid disease of the pericardium is rarely observed. The case of a 42-year-old man with intrapericardial hydatid cyst is presented. The first symptom of the disease was severe chest pain with electrocardiographic evidence of Q waves and T negative waves suggestive of myocardial necrosis. The two-dimensional echocardiography revealed large cystic image localized in the lateral-inferior wall of the left ventricle. Surgical treatment was carried out without the aid of cardiopulmonary by-pass, although this had been contemplated. The patient is asymptomatic and all electrocardiographic abnormalities regressed three months after the operation. The development, natural history, complications, diagnosis and surgical therapy of intrapericardial echinococcosis are discussed.     

Cardiac hydatid cyst in a child]

Cardiac hydatid cyst is an uncommon disease, especially in children. The interventricular septum region is the most frequent localization. The cysts usually involve other organs making the etiologic diagnosis easier. Our young patient presented a single hydatid cyst. The etiologic diagnosis was difficult due to the negativity of the serologic tests and there were no other organs affected. Surgical ablation of the cyst was performed and histopathological analysis achieved.     

Aneurysm of the sinus of Valsalva. Apropos of a case of right intra-atrial rupture

An unusual systolo-diastolic heart murmur was discovered fortuitously in a 39-year-old man undergoing a routine check-up. Transesophageal echocardiography gave the diagnosis of Valsalva sinus aneurysm ruptured into the right atrium. Cardiac surgery was successful. We reviewed the literature on this unusual condition, focusing on the pathophysiological, clinical, diagnostic and therapeutic aspects. Transesophageal echocardiography provides the diagnosis.     

Solitary subcutaneous hydatid cyst: a case report

In the absence of hepatic and pulmonary involvement, hydatid disease of other organs is extremely rare. In this paper, we report on a patient who had a solitary subcutaneous hydatid cyst in the submandibular region.     

Ruptured cerebral hydatid cyst: a case report

In this report we describe a case of cerebral hydatid cyst which ruptured into the subarachnoid space and suggest points which help in the preoperative diagnosis.     

Giant hepatic hydatid cyst： A case report

Large type 1 cysts are prone to perforation. Furthermore, insufficient drainage with subsequent abscess is a frequent problem of large cysts. We report here a case of a 19-year old man who was admitted to the hospital with pain in the right upper quadrant and epigastric region. An asymmetrical right upper quadrant enlargement was detected on physical examination. Ultrasonography and computerized tomography revealed a type 1 giant hydatid cyst in the right hepatic lobe, measuring 16 cm in diameter. During operation, partial cystectomy and drainage were done. The large dead space was obliterated by the ‘sandwich’ method. Omentum and gelatin sponges were used to fill the cavity. The postoperative period was uneventful and the patient was discharged on the 5th postoperative day.     

Mediastinal hemangiopericytoma. Apropos of a case]

The authors report a new case of hemangiopericytoma in an elderly man. An asymptomatic mediastinal mass was found on a routine chest film. C.T. guided fine-needle biopsy was diagnostic. These rare lesions are clinically and radiologically aspecific and require pathologic proof. The value of percutaneous biopsy before therapeutic decision is emphasized.