Presentation
One year history of chest pain with dyspnea.
Patient Data
There is a multilobulated cystic mass of the upper, and middle anterior mediastinum, lateralized to the right, composed of numerous contiguous cysts of various sizes, in contact with the chest wall anteriorly, and great mediastinal vessels posteriorly with encasement of the right brachiocephalic vein. The meticulous analysis shows that every cyst contains numerous daughter cysts. One of the cysts shows a calcified wall. No enhancement seen on postcontrast images.
No associated pulmonary cyst is seen.
Case Discussion
The hydatid serology tests were positive.
The mediastinal hydatid disease is very rare even in endemic areas 1, around 108 cases were reported in the literature 2. The clinical symptoms depend on the size, and location of the cysts as well as the involvement of the adjacent mediastinal structures 2. The mediastinal hydatid disease may be primary or the result of the mediastinal spread of the rupture of pulmonary hydatid cyst 2.
CT and MRI are best imaging modalities for evaluation of the mediastinal hydatid disease and rule out other differential diagnoses such as thymoma or teratoma with necrotic components 2.
Additional contributor: A. Ramdani, MD
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