Recurrent pulmonary hydatid disease: analysis of ten cases

To investigate the incidence and define the importance of recurrent pulmonary hydatid cysts in developing countries.

We analyzed the records of 312 patients with pulmonary hydatid cyst disease diagnosed in our center between 1999 and 2005.

A recurrent pulmonary hydatid cyst was diagnosed in 10 (3.2%) of the 312 patients [8 men and 2 women, mean age 36.9 (range 20-60) years]. The diagnosis was based on radiographic, clinical, or serological findings, established intraoperatively. The most frequent symptom of recurrent pulmonary hydatid cyst was hemoptysis (60%). The mean interval between diagnosis of the initial hydatid cyst and detection of recurrence was 8.75 (range 3-15) years. Bronchoscopy was performed in all patients, but proved diagnostic in only one. The localization of the initial and recurrent cysts differed in seven patients. A median follow-up period of 5 years revealed second recurrences in only two patients; manifesting as an intrapleural rupture of the cyst in one and as empyema in one. The recurrence was treated by resection in all patients; as cystectomy in eight patients, lobectomy in one patient, and pneumonectomy in one patient.

Pulmonary hydatid cyst may recur in the same or a different location in the lung. Patients with a pleural lesion must be followed up regularly for any signs of recurrence.