[Particular localisation of hydatic disease--sternum]

Bones localization of hydatic disease is extremely rare (0.5-2.5 %). In approximative 50% of the cases of bones hydatidosis, the cysts are localized at spines vertebrae, broad bones and mandible. We present a case of a 38 years old female. The patient related an insidious beginning of symptoms, about 3-4 years before, with anterior chest pain, and 3-4 month before hospitalization, the presence of a sternal tumor, in upper portion of the bone. Clinical examination of the patient showed a sternal tumor, at manubrium, painful at palpation, increased consistency, with local inflammation signs. Also, the patient related pain at sterno-clavicular articulation, increased by left upper limb motions, but without mobility restriction. Biochemical analysis revealed an moderate inflammatory syndrome: blood cell sedimentation speed = 40 mm/h, WBC = 9600/mmc, E = 3%, Hb = 11.8g/100ml, alcaline and acid phosphatase - normal range. Thoracic scan: sternal tumor at manubrium with invasion at sternoclavicular joint and bone destruction. Intraoperative we discovered that the sternal tumor was in fact an hydatic cysts, confirmed by the anatomo-pathological exam; we performed cysts removal and resection of osteitic bone. Postoperative outcome was favorable, with antiparasitic treatment after surgery; no recurrence of the hydatic disease or secondary localization.