A rare case of numerous hydatid cysts in the pleural cavity without extrapleural involvement

Abstract

Introduction and importance: The Echinococcus Granulosus, an endemic parasite in several parts of the world which causes hydatid disease. Human acts as an intermediate host and gets infected by eating parasitic eggs. As it is well known, lungs and liver are the most commonly involved organs in this disease. When the pleura is involved, it is almost always secondary to a ruptured primary lung cyst. Case presentation The purpose of this paper is to present a case of 16-year-old male with complaints of dyspnoea and dry cough for 6 months. His vital signs, CBC, and laboratory tests were all within normal. Chest X-ray showed a complete opacification of hemithorax. Clinical discussion CT revealed multiple cysts filling up the whole pleural cavity with collapsed lung and to-left mediastinal shift. The patient was diagnosed with primary pleural hydatidosis. The treatment was surgical, followed by parasitic medications. During the surgery, surgeons were able to simply extract many cysts by hand and eventually the collapsed lung returns to its normal volume and normal functional state. The patient was indicated to continue with Albendazole for 1 year after surgery. Three days after the surgery, chest X-ray was within normal. Conclusion Primary pleural hydatidosis is such a rare case to present as full filled up pleural cavity and a complete opacification of hemithorax on CXR. Using the developed technical methods helped to confirm such case and in choosing the best surgical intervention. The result was satisfactory with fully expanded and functional lung.

A primary pleural hydatid cyst was discovered months after an undiagnosed pneumothorax: A diagnostic and therapeutic dilemma in a rare case report from Syria

“…Although the pathogenic mechanism of pleural fibrosis in our patient is not fully understood, it caused a trapped and atelectatic lung as a natural consequence of the presence of the peel that caused its collapse, prompting the surgeon to perform surgical decortication of the lung. A case similar to ours was reported by Bara et al where the patient developed pleural thickening due to the hydatid cyst, which resulted in a trapped lung [ 3 ]. CT, X-ray, and ultrasound are all diagnostic methods that are useful for planning surgery for cysts.…”

“…The most common organs affected by the cysts are the liver and lungs, but they can also occur in other sites such as the bones or the pericardium. However, the pleural cavity is a very rare location for primary hydatid cysts [ 3 ]. In this report, we present a rare case of a 28-year-old female who was diagnosed with a large primary hydatid cyst in the intrapleural cavity after being admitted with severe dyspnea.…”

Pneumothorax Revealing the Rupture of a Primary Pleural Hydatid Cyst

“…In our case, imaging played a critical role, almost confirming the diagnosis preoperatively. Surgical intervention and subsequent parasitological examination validated the previously obtained imaging data and established a definitive diagnosis [8].…”