Multivesicular mediastinal hydatid cyst presenting with left recurrent and phrenic nerve palsy

Hydatid disease caused by Echinococcus granulosus is endemic in Indian subcontinent and a common surgical problem. Although hydatid cyst is common in the liver and lung, it can be encountered in almost every part of the body. Mediastinal hydatid disease is a rare occurrence and only a few cases have been reported in the literature.The present article reports a case of a multivesicular mediastinal hydatid cyst associated with nerve palsies.The patient presented with left recurrent nerve and phrenic nerve palsy. Ultrasonography (US) and computed tomography (CT) of the thorax revealed a multivesicular cyst in the superior mediastinum, the cyst fluid was aspirated and sent for cytology which confirmed the echinococcus as the cause of cystic lesion. Surgical exploration was done by left anterolateral thoracotomy and the cyst was excised. The aim of the present article is to make the reader aware of such rare presentation of hydatid disease especially in endemic areas.