Godazandeh Gholamali, Mokhtari-Esbuie Farzad, Azooji Sara
Department of Thoracic Surgery, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
Department of General Surgery, School of Medicine, Iranshahr University of Medical Sciences, Iranshahr, Iran.
Iran J Med Sci. 2020 May;45(3):220-223. doi: 10.30476/ijms.2019.82036..
Hydatid disease (HD) is an infectious disease caused by echinococcosis. Hydatid cyst (HC) most commonly invades the liver (60-70%) and the lungs (20-25%). However, other parts of the body and even unusual locations can be infected, mimicking a benign lesion that could be easily missed. Primary HC of the chest wall is extremely rare, even in countries where echinococcosis is endemic. We herein present a case of a 40-year-old man with a right-sided growing thoracic wall mass. The patient did not present the relevant history (living in rural areas or being in contact with farm animals) and the serological examination with the indirect hemagglutination test was negative. During surgery, a cystic mass between the eleventh and twelfth ribs was observed. The thoracic wall mass extended to the posterior abdominal wall and was entirely extrapulmonary and extraperitoneal. All cystic structures of the thoracic wall and intrathoracic region were removed, and the primary defect was reconstructed. In endemic areas such as Iran, HD should be considered in the differential diagnosis of mass lesions located in the chest wall or other parts of the body, even without the relevant history or serologic evidence.
包虫病（HD）是一种由棘球蚴病引起的传染病。包虫囊肿（HC）最常侵犯肝脏（60 - 70%）和肺（20 - 25%）。然而，身体的其他部位甚至不常见的部位也可能被感染，表现为良性病变，很容易被漏诊。胸壁原发性HC极为罕见，即使在棘球蚴病流行的国家也是如此。我们在此报告一例40岁男性患者，其右侧胸壁有一逐渐增大的肿块。患者无相关病史（居住在农村或接触农场动物），间接血凝试验血清学检查为阴性。手术中，在第11和第12肋骨之间观察到一个囊性肿块。胸壁肿块延伸至后腹壁，完全位于肺外和腹膜外。切除了胸壁和胸腔内区域的所有囊性结构，并修复了原发缺损。在伊朗等流行地区，即使没有相关病史或血清学证据，在胸壁或身体其他部位肿块病变的鉴别诊断中也应考虑包虫病。
