Mohamed Guelbi, Mehdi Trabelsi Mohamed, Neirouz Kammoun, Sadok Boudaya Mohamed, Jerraya Hichem
Department B of Surgery, Charles Nicolle Hospital, Tunis, Tunisia.
Department B of Surgery, Charles Nicolle Hospital, Tunis, Tunisia.
Int J Surg Case Rep. 2025 May;130:111322. doi: 10.1016/j.ijscr.2025.111322. Epub 2025 Apr 21.
Several organs can be affected by the parasite "Echinococcus granulosus" including lungs and liver. Due to its great variability and different clinical presentation every treatment should be tailored to each case. Through our case of synchronous liver and lung hydatid cyst, we aim to discuss one of the options available.
An 8-year-old female patient, consulted for a thoracic spine pain and a heaviness in the right hypochondrium related to both lung and liver cysts. A thoraco-abdominal computed tomography (CT) scan revealed cystic mass in the right lower lobe exerting a mass effect on the adjacent lung parenchyma. It showed also a hepatic cystic mass of the V and VI segments. The diagnosis of synchronous hydatid cyst of the liver and lung is retained. We opted for the two-stage approach because of the location of the cyst and the age of the patient. We started with the lung cyst she had a lobectomy through a right thoracotomy. One month later she had a total cystectomy with a cholecystectomy via a right subcostal incision. Both procedures were uneventful, with no recurrence at 6-month follow-up.
Simultaneous lung and liver cysts are rare, complicating management strategies. In this case, a two-stage radical resection was chosen. Radical surgery has been shown to lower complications and recurrence compared to conservative methods, making it the preferred option in our case.
This case highlights the role and the viability of two-stage approach for treating synchronous pulmonary and hepatic hydatid cyst.
几种器官可受到寄生虫“细粒棘球绦虫”的影响，包括肺和肝。由于其高度变异性和不同的临床表现，每种治疗都应根据具体病例量身定制。通过我们同步出现肝肺包虫囊肿的病例，我们旨在探讨一种可行的治疗方案。
一名8岁女性患者，因胸椎疼痛及与肺和肝囊肿相关的右季肋部沉重感前来就诊。胸腹计算机断层扫描（CT）显示右下叶有囊性肿块，对相邻肺实质产生占位效应。还显示肝V段和VI段有一个肝囊肿性肿块。确诊为肝肺同步包虫囊肿。由于囊肿位置和患者年龄，我们选择了两阶段治疗方法。我们先处理肺囊肿，通过右胸切开术进行了肺叶切除术。一个月后，通过右肋下切口进行了全囊肿切除术和胆囊切除术。两个手术均顺利，6个月随访无复发。
同时出现肺和肝囊肿的情况罕见，使治疗策略复杂化。在本病例中，选择了两阶段根治性切除术。与保守方法相比，根治性手术已显示出可降低并发症和复发率，使其成为我们病例中的首选方案。
本病例突出了两阶段治疗方法在治疗同步性肺和肝包虫囊肿中的作用及可行性。
