# Delayed Surgical Treatment of a CE1 Lung Cyst Resulting in Pericystectomy of CE4 Cyst

## TL;DR

A lung CE1 cyst progressed to CE4 due to delayed surgery during the first wave of the pandemic, requiring a more aggressive surgical approach.

## Contribution

Reports a rare case of a CE4 lung cyst resulting from delayed treatment and its clinical implications.

## Key findings

- Delayed surgical treatment caused a CE1 lung cyst to progress to CE4.
- Pericystectomy was required instead of the standard endocystectomy for the advanced cyst stage.
- Clinical and imaging features of a rare CE4 lung cyst were documented.

## Abstract

Lung is the second most common locationof cystic echinococcosis (CE), after the liver. Diagnosis of lung CE is often incidental, and clinical manifestations depend on the location and size of the cyst, the most common being chest pain, shortness of breath, expectoration of fragments of endocyst, and haemoptysis. Surgery is the primary treatment, with a minor role for medical therapy. Delayed diagnosis and treatment may have important consequences. We present a case of lung CE in whichsurgical treatment was delayed due to the first wave of COVID-19. Since surgery could not be performed immediately, the patient was kept on albendazole and the cyst stage moved from CE1 to CE3a, to CE4, eventually requiring a more aggressive pericystectomy instead of the commonly performed endocystectomy. The clinical and imaging characteristics of a rare CE4 cyst of the lung are reported.