Primary heterotopic pleural hydatid cyst presenting as a pneumothorax

Introduction. - Hydatid cyst is a parastic disease that is endemic in many countries. Pneumothorax may be a presention of this disease that presents urgent problems of diagnosis and treatment. Case report. - We report the case of a 23-year-old woman, amenorrheic for 22 weeks, who presented with chest pain and dyspnoea. Chest x-ray revealed a right-sided tension pneumothorax. A check x-ray after drainage showed a homogeneous opacity of water density occupying the lower 2/3 of the right hemithorax. Thoracic ultrasound suggested an uncomplicated hydatid cyst at the right base. Surgical exploration revealed a hydatid cyst 14 cm in diameter in the pleural space, and a cavity in the right lower lobe with two bronchial fistulae. Treatment consisted of removal of the cyst intact, closure of the bronchial fistulae and capitonnage of the residual cavity. The postoperative course was uncomplicated. Conclusion. - Primary heterotopic pleural hydatid cyst is an exceptional cause of pneumothorax that should considered in countries where hydatid disease is endemic. Treatment is surgical following drainage of the pneumothorax. (C) 2011 SPLF. Published by Elsevier Masson SAS. All rights reserved.