# A Rare Case of Mediastinal Hydatidosis With Cardiac and Vascular Compression

## TL;DR

A rare case of a hydatid cyst in the chest compressed the heart and aorta, successfully treated with surgery and medication.

## Contribution

This case highlights the rare and challenging presentation of mediastinal hydatid disease with cardiac and vascular compression.

## Key findings

- A 48-year-old man with a history of hydatid disease developed a large mediastinal cyst compressing the heart and aorta.
- Successful surgical removal and postoperative albendazole therapy led to full recovery.
- Imaging was crucial for diagnosis and surgical planning in this complex case.

## Abstract

Hydatid disease is a parasitic zoonosis caused by Echinococcus granulosus, typically transmitted through contact with infected dogs or ingestion of contaminated food. Although the liver and lungs are the most commonly affected organs, mediastinal localization is extremely rare and presents diagnostic and therapeutic challenges. This report describes the case of a 48-year-old man with a history of hepatic and pulmonary hydatid disease who developed a retrocardiac mediastinal hydatid cyst (HC). The patient presented with cough, dyspnea, and back pain. Imaging (computed tomography (CT) and magnetic resonance imaging (MRI)) revealed a 9.3 × 7.0 cm cyst compressing mediastinal structures, including the atria and aorta. Surgical removal via posterolateral thoracotomy was performed successfully, and the patient recovered without complications. Albendazole was administered to the patient over a six-month period as part of the postoperative antiparasitic treatment. Echinococcus granulosus causes HCs, a significant zoonotic and pulmonary parasitic disease that can mimic various pathologies and is often harder to manage than the disease itself. HC is considered a significant health problem in India, Iran, China, and Mediterranean countries, which lack satisfactory environmental health, preventive medicine, and veterinarian services. Echinococcosis continues to be a major community health burden in several countries, and in some terrains, it constitutes an emerging and re-emerging disease. Cystic echinococcosis is the most common human disease of this genus, and it accounts for a significant number of cases worldwide. Imaging plays a key role in diagnosis and surgical planning, while surgery remains the mainstay of treatment, supported by medical therapy.