Althobaity Waleed, Aldeheshi Ayman, Bin Saeedan Mnahi
Department of Radiology, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia.
Department of Pathology & Laboratory Medicine, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia.
Case Rep Radiol. 2023 Apr 13;2023:5313067. doi: 10.1155/2023/5313067. eCollection 2023.
Primary chest wall hydatid cyst is a very rare disease in endemic areas. This case report describes a 22-year-old male patient with a 3-year history of chronic left chest pain. He had a history of close animal contact in childhood. Chest computed tomography (CT) scan showed a left upper posterior paravertebral cystic mass with peripheral and intrinsic calcifications. Fluorine-18 fluorodeoxyglucose (F-18 FDG) positron emission tomography (PET) scan showed no significant FDG uptake. Magnetic resonance imaging (MRI) showed a left paravertebral cystic mass with daughter cysts and a peripheral low T2 wall, compatible with hydatid disease. Medical treatment was started, and a follow-up MRI showed rupture of hydatid cysts. The patient underwent surgical resection, and a hydatid disease diagnosis was confirmed by histopathologic examination. During the postoperative hospital course, the patient developed pneumothorax which was successfully treated with a surgical procedure. The patient was discharged with medical treatment (albendazole). In conclusion, this case highlights the importance of considering hydatid disease in the differential diagnosis of chest wall cystic masses, especially in endemic regions, and the value of multimodality imaging in diagnosis and treatment planning.
原发性胸壁包虫囊肿在流行地区是一种非常罕见的疾病。本病例报告描述了一名22岁男性患者，有3年慢性左胸痛病史。他童年时有密切动物接触史。胸部计算机断层扫描（CT）显示左后上椎旁囊性肿块，伴有周边和内部钙化。氟-18氟脱氧葡萄糖（F-18 FDG）正电子发射断层扫描（PET）显示无明显FDG摄取。磁共振成像（MRI）显示左椎旁囊性肿块，伴有子囊和周边低T2壁，符合包虫病表现。开始进行药物治疗，随访MRI显示包虫囊肿破裂。患者接受了手术切除，组织病理学检查确诊为包虫病。在术后住院期间，患者发生气胸，通过手术成功治疗。患者出院时接受药物治疗（阿苯达唑）。总之，本病例强调了在胸壁囊性肿块鉴别诊断中考虑包虫病的重要性，特别是在流行地区，以及多模态成像在诊断和治疗规划中的价值。
