Motaş C, Motaş N, Davidescu M, Rus O, Horvat T
Clinica de Chirurgie Toracică, Institutul Oncologic "Prof. Dr. Al. Trestioreanu", Bucureşti, România.
Chirurgia (Bucur). 2012 Jan-Feb;107(1):115-8.
Echinococcosis is endemic in Romania. Hydatid cyst can develop in any segment or organ, but the most frequent locations are liver and lung. Mediastinal hydatid lesions are extremly rare and only a few cases exists in the medical literature.
Between 1994 and 2011 Thoracic Surgery Clinic, UMF "Carol Davila" there were 3 patients diagnosed and surgical trated for hydatid cyst of mediastinum. The patients were 2 men and 1 woman aged of 20, 37 and 52 years. All hydatid cysts were located in the anterior mediastinum and all were solitary lesions when diagnosed.
In 1 case the positive diagnosis was made preoperatively, in the other 2 the diagnosis was intraoperative. The approach was through thoracotomy. One cyst was complicated (nonviable thymic hydatid cyst), treated by ideal cystectomy, and 2 cysts were viable. There was 1 postoperative complication: gaseous cerebral embolism remitted after medical treatment, caused by the intraoperative use of H2O2 as scolicide agent.
Although very rare, anterior mediastinal hydatid cysts must be considered in every patient with anterior mediastinal mass. Complete surgical excision is the treatment of choice; surgery followed by parasiticide therapy provides complete cure.
棘球蚴病在罗马尼亚呈地方性流行。包虫囊肿可在任何节段或器官中形成,但最常见的部位是肝脏和肺。纵隔包虫病变极为罕见,医学文献中仅有少数病例报道。
1994年至2011年间,“卡罗尔·戴维拉”医科大学胸外科诊所对3例纵隔包虫囊肿患者进行了诊断并实施了手术治疗。患者为2名男性和1名女性,年龄分别为20岁、37岁和52岁。所有包虫囊肿均位于前纵隔,诊断时均为孤立性病变。
1例术前确诊,另外2例术中确诊。手术方式为开胸手术。1个囊肿为复杂性(无活力的胸腺包虫囊肿),采用理想的囊肿切除术治疗,另外2个囊肿有活力。术后出现1例并发症:术中使用过氧化氢作为杀头节剂导致气体脑栓塞,经药物治疗后缓解。
尽管前纵隔包虫囊肿非常罕见,但每例前纵隔肿块患者均应考虑该病。完整的手术切除是首选治疗方法;手术联合杀寄生虫治疗可实现完全治愈。