Diaphragmatic hydatid disease: a diagnostic challenge for the radiologist

Primitive hydatid disease of diaphragm is very rare. The preoperative diagnosis of this hydatid location represents a challenge for the radiologist. We reported a case of primitive hydatid cyst of the diaphragm not associated with other hydatid localizations which was diagnosed preoperatively. A 70 year-old woman with no previous medical history, complained of abdominal pain in the right upper quadrant for 7 months. The physical exam and the laboratory tests were unremarkable. Abdominal ultrasound showed multiloculated cystic lesion which appeared to be located in the hepatic dome suggestive of hydatid cyst of the liver.  However, computed tomography showed findings but in favour of the diaphragmatic origin of the cyst which was confirmed peroperatively. Since the exploration of cysts lying between the thorax and the abdomen is difficult by ultrasound, computed tomography with multiplanar reconstruction appears to be indispensable in the preoperative assessment of hydatid cysts in contact with the diaphragm.