Pulmonary echinococcosis presenting as a pulmonary mass with fever and haemoptysis; a case report

Hydatidosis, which is caused by larval stage of Echinococcus granulosus, is the most frequently encountered type of anthropozoonosis, and it has been known for centuries. Due to the traditional close association between sheep, dogs and humans, Echinococcus granulosus is endemic in many parts of the world and particularly the Mediterranean countries. The case is reported of a 68 year-old man, a farmer and non smoker, who presented with a 32 day history of haemoptysis and fever. On chest X-ray a mass was observed at the hilum of the right lung. He underwent full clinical, laboratory, and endoscopic evaluation, which was unrevealing. During right thoracotomy a right lower lobectomy was performed that included the mass. Frozen section of the mass was negative for malignancy and the final histopathological examination established the diagnosis of a ruptured pulmonary echinococcus cyst with abscess formation. The postoperative course was uneventful and the patient was discharged from hospital on the ninth postoperative day being treated with albendazole per os. Pulmonary echinococcosis should be included in the differential diagnosis of a lung mass in patients presenting with haemoptysis, especially if there are domestic animals in their environment.