Concomitant Intrathoracic Extrapulmonal and Cervical Hydatid Cyst—a 10-Year Follow-up

Hydatosis is a clinical entity known since the time of Hippocrates with Echinococcus granulosus as most common cause of hydatidosis. Humans as well as herbivores are infected as intermediate hosts and the zoonosis is most commonly observed in the liver and lungs. Intrathoracic extrapulmonary cysts are uncommon. We present the rare presentation of concomitant intrathoracic extrapulmonary and cervical hydatid cysts after a follow-up of 10 years. The patient presented with a soft palpable supraclavivular mass and increasing pain. Thoracoscopic exploration (VATS, video-assisted thoracic surgery) revealed a cystic lesion at the apex of the left hemithorax without contact to the lung. We performed a cystotomy and removed the laminated membrane. Later, the cervical hydatid cyst was removed. Five years later, a recurrence of the disease was again resected. Currently, 10 years after initial referral, the patient remains without any signs of active disease. To our knowledge, this is the first report of an intrathoracic extrapulmonary hydatidosis removed by VATS. Our report presents VATS as a surgical option in the treatment of intrathoracic extrapulmonary hydatid disease of the thoracic apex and confirms the feasibility of minimal invasive surgery for intrathoracic hydatid disease.