Primary Hydatid Cyst of the Thoracic Aorta Revealed by Peripheral Arterial Embolism

Abstract

Primitive aortic hydatidosis is exceptional. We report the case of a 55-year-old woman who had pain in her left lower limb for a week. A computed tomographic angiogram showed a multivesicular and fluid-density mass intimately contiguous to the descending thoracic aorta seen on an endoluminal subtraction image and hydatid cysts in the spleen. The surgical approach was through a thoracophrenolombotomy with right femorofemoral bypass. Complete resection of the destroyed aortic portion was performed, and continuity was restored by an aortoaortic bypass using a Dacron (INVISTA, Kennesaw, Georgia) prosthesis. Hydatid fragments were evacuated after thrombectomy of the left iliac artery. The surgical procedure was completed by a splenectomy. Postoperative follow-up was uneventful. After 6 months, computed tomographic angiography showed a patent bypass.

Hydatid cyst of the middle mediastinum complicated by fistulated ascending aorta: A case report and review of the literature

“…Previous case reports noted chest pain, recurrent arterial embolic events, and even asymptomatic presentation. 7 , 8 , 9 Preoperative diagnosis of extrahepatic and pulmonary hydatid cysts is challenging, even in endemic areas, unless there is a specific consideration for a hydatid cyst. Previous studies recommended that digital subtraction angiography, CT scan, MRI, and ultrasound as effective approaches for detecting the exact relation of cysts and aorta walls in thoracic and aortic hydatid cysts.…”

“…Hydatid cysts that involve the aorta were reported with different clinical presentations based on the hydatid cyst location, extension, and complications. Previous case reports noted chest pain, recurrent arterial embolic events, and even asymptomatic presentation 7–9 . Preoperative diagnosis of extrahepatic and pulmonary hydatid cysts is challenging, even in endemic areas, unless there is a specific consideration for a hydatid cyst.…”

Saccular mycotic aneurysm of descending thoracic aorta secondary to vertebral hydatid disease: A rare case

“…also reported a saccular aneurysm of the descending thoracic aorta that was replaced by an open approach. 3 Hydatid cysts adjacent to the aorta can also invade the aortic lumen and cause false aneurysms. Management still necessitates surgical repair.…”

A Rare Case of Primary Posterior Mediastinal Hydatid Cyst with False Aortic Aneurysm

“…In another way primarily arterial wall involvement may be caused by parasite entering the vasa vasorum of the relevant artery through a defect in the intima. [4].…”