Mediastinal Hydatid Cyst: A Case Report with Diagnostic and Imaging Approach

Abstract

Hydatid disease, caused by the parasite Echinococcus granulosus, is a parasitic infection that mainly affects the liver and lungs. However, in rare cases, the disease can involve other organs such as the mediastinum, the central compartment of the thorax. Hydatidosis is a zoonosis caused by Echinococcus granulosus, and remains a significant public health issue in Mediterranean countries. Mediastinal hydatid cyst is an extremely rare manifestation and poses a diagnostic challenge when based solely on clinical presentation. This paper discusses the clinical, radiological, and therapeutic aspects of mediastinal hydatid cysts, with a focus on recently published cases and complications. While many cases are incidentally discovered, complications may occur in some patients. Nevertheless, hydatid disease should be considered in the differential diagnosis of mediastinal masses in endemic regions. We report the case of a 36-year-old female farmer with no notable medical history, but with regular exposure to dogs. She presented with progressively worsening back pain. Radiological investigations, including plain chest X-ray and cervico-dorsal MRI, revealed a posterior mediastinal hydatid cyst appearing hyperintense on T2 and hypointense on T1, with a bilayered wall containing daughter vesicles and extension into the spinal canal with visible compression. This case underscores the importance of considering echinococcosis in the differential diagnosis of mediastinal masses, even in the absence of typical symptoms. Although rare, mediastinal hydatid cysts must be considered, especially in endemic regions. Early recognition, accurate imaging, and proper surgical management offer excellent outcomes and help prevent serious complications.