Page 92 - Livre électronique des Rencontres Franco-Tunisiennes de Pneumologie 2019

P55. JUVENILE PRIMARY MEDIASTINAL HYDATID CYST

MOUNA GUERMAZI, NESRINE REGAÏEG, SOUAD YAHYAOUI, SALEM BOUOMRANI

SERVICE DE MEDECINE INTERNE, HOPITAL MILITAIRE DE GABES 6000-TUNISIE

Introduction: Echinococcosis is a zoonosis that is still endemic and represents a major public health
problem in many parts of the world, including Tunisia. The primitive forms of the unusual locations
(extra-pulmonary and extra-hepatic) of this parasitosis are exceptional: only 0.9% in the series of
Lianos GD et al collected over 33 years of experience. We report an original case of juvenile
primary mediastinal hydatid cyst.
Case report: A 12-year-old patient, with no notable pathological history, was explored for right
lateral thoracic pain, progressive worsening for two months, with recent dyspnea.

Somatic examination, electrocardiogram, and basic biological assessment were without
abnormalities. Chest X-ray showed a right, well-defined, homogenous para-cardiac opacity, which
proved to be in the posterior mediastinum on the right profile view of chest radiograph. Further
investigation concluded to a primary and isolated mediastinal hydatid cyst. The patient was
operated through a posterolateral thoracotomy with simple operative follow-up, and a subsequent
favorable evolution.

Conclusion: As exceptional as it is (in the large series of 235 cases of intrathoracic echinococcosis
arising in 222 juvenile patients, only two cases of mediastinal hydatid cyst were noted (0.85%)),
this location of the hydatic disease deserve to be known and evoked in front of any respiratory
signs that is not proven, especially in endemic countries, because its potential complications may
be life-threatening.

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