Multimodal imaging for the diagnosis of cardiac alveolar echinococcosis: a case report

Primary cardiac echinococcosis is rare, and cardiac alveolar echinococcosis is even rarer and more unusual. Reported cases of this disease are extremely limited, and multimodal imaging provides an important guide to treatment and decision-making. We report a case of cardiac alveolar echinococcosis. A 31-year-old male patient with no significant history was diagnosed to have a space-occupying lesion in the mediastinum. Transthoracic echocardiography showed a cystic mass anterior to the right lateral aspect of the right atrium, which did not show enhancement on the enhanced scan. Multidetector computed tomography (MDCT) and cardiac magnetic resonance showed a cystic space-occupying lesion in the right lateral aspect of the right atrium, with mild enhancement of the edges of the lesion and multiple small vesicles on the enhancement scan. Clinicians operated on the patient under suspicion of cardiac echinococcosis and successfully removed the lesion. Ultimately, postoperative histopathologic examination revealed cardiac alveolar echinococcosis. The patient recovered well and was discharged with regular postoperative oral albendazole tablets and regular follow-up reviews.

We report a case of cardiac alveolar echinococcosis with multimodal imaging features and therapeutic strategies, an extremely rare cardiac occupying disease. Multimodal imaging is of great help in the diagnosis of this disease, and surgical resection and histopathological diagnosis are essential. After surgery, treatment and follow-up will be carried out based on the results of the histological examination. This rare case emphasizes the integrated diagnosis of cardiac alveolar echinococcosis with clinical, multimodal imaging and pathologic data.