An unusual localization of cyst hydatidosis associated with cardiac hydatid disease/Hidatik kistin ahsilmadik lokalizasyonu ve kardiyak kist hidatikle beraberligi.
A 50-year-old woman was admitted to our clinic for surgical removal
of cardiac hydatid cyst. Before the admission, she had been referred to
other clinic with signs and complaints of a large mass in the medial
aspect of the left upper leg and severe pain. A multiloculated hydatid
cyst between the iliopsoas and pectineus muscle had been diagnosed using
an ultrasonography and magnetic resonance imaging (MRI). Magnetic
resonance images demonstrated a well-defined cystic mass containing a
few round lesions. The mother cyst had a thin, low-signal intensity rim
on T1 and T2 weighted sequences. The daughter cyst exhibited a very low
signal on T1-weighted images. Indirect hemagglutination and Western-Blot
tests for echinococcus antibodies were also positive. After the
diagnosis, albendazole 10 mg/kg daily for three months had been given
immediately. At the follow-up, the symptoms disappeared and the MRI
confirmed that the amount of the cystic lesions have decreased and
became calcified (Fig. 1). But, transthoracic echocardiography and chest
computed tomography revealed a cardiac hydatid cyst, 19x13 mm in size,
originated from the interventricular septum (Fig. 2 and Fig. 3).
Therefore, the patient underwent operation for removal of hydatid cyst
in interventricular septum. We prescribed albendazole 10 mgr/kg daily
for three months to prevent recurrence postoperatively.
[FIGURES 1-3 OMITTED]
This case emphasizes that in endemic areas with high occurrence of
hydatid infestation, physicians should have a high index of suspicion when patients present with slowly growing cystic mass in musculoskeletal
system. The preoperative workup including ultrasonography, transthoracic
echocardiography, and total body computed tomography must be performed
routinely as we show in this case.
Cok ileri bir tarihte
Cok yasli olarak
Kimseye pek gozukmeden
Ve kimseyi rahatsiz etmeden.
Dunden kalan isler
Okunmayi bekleyen kitaplar
Ve anilar ve umutlar.
Filleri kuyrugundan cekerek
Tepeleri asirtmakti gorevim
Gunler bitti filler tukenmedi
Ben elimden geleni yaptim
Gerisini siz tamamlayin.
Bosa gecmedi hayatim
Daha fazlasi olabilirdi ama
'Buna da ?ukur' demeliyim
Iste sevgili dostlar
Ben boyle veda etmeliyim.
New York, 1995
Metin Demircin, Omer Faruk Dogan, Meral Kanbak *
From Departments of Cardiovascular Surgery and * Anesthesia,
Medical Faculty, Hacettepe University, Ankara, Turkey