Cardiac echinococcosis: Surviving 40 years later?

Yolanda Carrascal, Jaime Arroyo, Horacio Valenzuela y Mireia Fernandez

A 60-year-old male presented with pulmonary hydatid cyst excision (after vomica with hemoptysis) when aged 20 years. He was referred with a cystic mass in interventricular  septum, in magnetic resonance imaging (MRI) (Fig. 1). Due to high suspicion of hydatic cyst (it can remain latent up to five decades), surgical treatment was decided (Fig. 2).

Figure 1. Cardiac Echonococcosis
Figure 1: After a syncopal episode, MRI identified a bilobulated cystic mass in interventricular septum, externally protruding to ventricular diaphragmatic surface, and extending upwards membranous septum (48.54 × 65.63 mm).
Figure 2. Cardiac Echonococcosis
Figure 2: (A) Open hydatic cyst with ‘caseum’ content. Neither daughter cyst nor scoleces or cuticular membrane was identified. Pathological analysis described cyst content as a ‘caseum’, probably secondary to degenerative hydatic cyst necrosis. (B) Complete hydatic cyst after surgical resection.



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