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Case Reports
. 2023 Sep 25;2023(9):omad099.
doi: 10.1093/omcr/omad099. eCollection 2023 Sep.

The silent invader: a case of intrapericardial hydatid cyst with exceptional pulmonary artery involvement

Aida Soufiani  1 , Samah El-Mhadi  2 , Hamza Chraibi  2 , Zineb Agoumy  2 , Zineb Fassi Fehri  2 , Sanae Es-Sebbani  2 , Hasnaa Leghlimi  1 , Omar Ech-Cherif El Kettani  1 , Fadoua Lachhab  1 , Mohammed Tribak  1 , Rokya Fellat  2 , Nesma Bendagha  2 , Said Moughil  1
Affiliations
Case Reports

The silent invader: a case of intrapericardial hydatid cyst with exceptional pulmonary artery involvement

Aida Soufiani et al. Oxf Med Case Reports. .

Abstract

A 70-year-old woman was referred to our cardiology department for the management of dyspnoea. Cardiovascular examination revealed a loud P2, with no sign of right-sided heart failure. Chest X-ray showed a convex left medium cardiac border and a double contour along the right cardiac border. Transthoracic echocardiogram revealed a cystic mass attached to the right ventricle apex. Computed tomography scan showed cyst with fluid density on the apex of the right ventricle; and a honeycomb-like aspect cyst with partial occlusion in the left pulmonary artery. Cardiac magnetic resonance imaging revealed the presence of hydatic intrapericardial cyst that compresses the right ventricular apex; associated with intraluminal left pulmonary artery cyst. Hydatic serology was positive. The patient refused surgery and was discharged on a regimen of Albendazole. She has been followed up closely with a good outcome.

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Conflict of interest statement

No conflicts of interest.

Figures

Figure 1
Figure 1
TTE: modified parasternal long axis view showing a hyperechoic cystic mass (yellow star) next to the right ventricular apex. RV: right ventricle; RA: right atrium.
Figure 2
Figure 2
CT scan: axial (A) and sagittal (B) views showing hydatic intrapericardial cyst (yellow star) on the right ventricle’s apex. RA: right atrium; RV: right ventricle; LV: left ventricle.
Figure 3
Figure 3
CT scan: axial (A + B) and sagittal (C + D) views showing a multivesicular hydatic cyst (green circle) class CE2 WHO, with severe reduction of the flow and partial occlusion of the left pulmonary artery. MPA: main pulmonary artery.
Figure 4
Figure 4
Cardiac magnetic resonance imaging (MRI) showing hydatic intrapericardial cyst (yellow scar) involving the myocardium at the right ventricular apex, with intermediate signal on T2-weighted imaging (A: axial view, D: sagittal view), iso-intense to myocardium on T1-weighted imaging (B: axial view) and hypo-intense to myocardium on late gadolinium enhancement (LGE) axial view (C). RA: right atrium; RV: right ventricle; LV: left ventricle.
Figure 5
Figure 5
Cardiac MRI: cine axial view (A) and cine sagittal view (C) revealing intraluminal active multivesicular honeycomb-like cyst in the left pulmonary artery, hypo-intense in LGE sequences (axial view: B, sagittal view: D). MPA: main pulmonary artery; RV: right ventricle.
Figure 6
Figure 6
TTE apical four chamber view (A) and CT scan axial view (B) showing intrapericardial hydatid cyst’s evolution to the class CE4/5 (WHO) 2 years after discharge.
See this image and copyright information in PMC

References

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