The two-stage approach for treating combined pulmonary and hepatic hydatid cyst: A case report

Several organs can be affected by the parasite "Echinococcus granulosus" including lungs and liver. Due to its great variability and different clinical presentation every treatment should be tailored to each case. Through our case of synchronous liver and lung hydatid cyst, we aim to discuss one of the options available.

An 8-year-old female patient, consulted for a thoracic spine pain and a heaviness in the right hypochondrium related to both lung and liver cysts. A thoraco-abdominal computed tomography (CT) scan revealed cystic mass in the right lower lobe exerting a mass effect on the adjacent lung parenchyma. It showed also a hepatic cystic mass of the V and VI segments. The diagnosis of synchronous hydatid cyst of the liver and lung is retained. We opted for the two-stage approach because of the location of the cyst and the age of the patient. We started with the lung cyst she had a lobectomy through a right thoracotomy. One month later she had a total cystectomy with a cholecystectomy via a right subcostal incision. Both procedures were uneventful, with no recurrence at 6-month follow-up.

Simultaneous lung and liver cysts are rare, complicating management strategies. In this case, a two-stage radical resection was chosen. Radical surgery has been shown to lower complications and recurrence compared to conservative methods, making it the preferred option in our case.

This case highlights the role and the viability of two-stage approach for treating synchronous pulmonary and hepatic hydatid cyst.