30 November 2021
: Case report 
Hydatid Pulmonary Embolism: A Case Report and Literature Review
Challenging differential diagnosis, Rare disease
Adila Aili1AEF, Liqing Peng2A, Jiarui Zhang1B, Yu Liu1B, Lige Peng1B, Qun Yi1A, Haixia Zhou1A*DOI: 10.12659/AJCR.934157
Am J Case Rep 2021; 22:e934157
Table 1. Reported cases of pulmonary embolism due to hepatic hydatid disease.
| Study | Patient age (years)/sex | Clinical presentation | Imaging manifestation | Location of hydatid cyst | Treatment | Outcome |
|---|---|---|---|---|---|---|
| Yague et al (1998) []3 | 44/Male | Hemoptysis | CT: 2 oval masses of 40 and 20 mm located in the pulmonary arteries; MR: hypointense in T1-weighted images and hyperintense in T2-weighted images | Right, left pulmonary artery | Surgery: thoracotomy | Not mentioned |
| Yuan et al (2014) []4 | 70/Male | Dyspnea, intermittent cough | Enhanced CT: low-density filling defect in the pulmonary artery, complete occlusion of the lumen | left lung lower lobe segmental pulmonary artery | Surgery | Not mentioned |
| Lioulias et al (2001) []5 | 57/Male | Left chest pain, dyspnea, cyanotic | CTA: cystic lesions, complete and partial occlusion of the relevant pulmonary arteries; MR-angiography: multiple cysts in the pulmonary artery | Left pulmonary artery, distal branches of the right pulmonary artery | Surgery: thoracotomy | After 42 months the patient is asympto-matic |
| Alper et al (1995) []7 | 55/Male | Dyspnea | CT: low-density lesions in the pulmonary artery, well-defined oval shape and with water density. MRI: a cystic lesion, hypointensity on Tl-weighted images and hyperintensity on T2-weighted images; a thrombosis lesion, moderately hyperintense on all sequences. Conventional pulmonary angiography: total occlusion of the relevant arteries | Right main pulmonary artery and left lower lobe artery | Surgery: Dissected right pulmonary artery | Not mentioned |
| Karantanas et al (2000) []8 | 67/Male | Dyspnea, cough, hemoptysis | Enhanced CT: multiple echinococcal cysts in both lungs and a hypodense mass located in the left pulmonary artery compatible with intra-arterial hydatid cyst. MRI: multiple cysts sub-pleurally with mild wall enhancement and a similar cystic lesion in the lumen of the left pulmonary artery | Left pulmonary artery | Mebendazole | After 19 months there has not been deterioration |
| Kokasal et al (2006) []9 | 24/Male | Cough, hemoptysis | CT: a para-hilar cavitated mass-like lesion, a cavitary lesion in the upper lobe and disseminated parenchymal infiltration in the right lung; right pulmonary artery was occluded with a hypodense lesion. MRI: complete occlusion of the right pulmonary artery | Right pulmonary artery | Surgery: Dissected right pulmonary artery | After 14 months no pathology has been detected |
| Akgun et al (2011) []10 | 43/Male | Hemoptysis, abdomen pain, chest pain, dyspnea | CT: multiple cystic emboli in the pulmonary arteries, vessel enlargement, multiple cystic parenchymal nodules in the lung lobes, and cystic embolus in the right atrium; the border between IVC and cystic component of the mass was undetermined Sonographic images: the border between the wall of the hydatid cyst and IVC was missing | IVC, pulmonary artery, right atrium | Albendazole | After 2 months the patient is asympto-matic |
| Herek et al (2012) []11 | 31/Female | Chest pain, dyspnea, cough | Ultrasonography: a giant hydatid cyst lesion in the liver measuring 15×10 cm and compressing the portal and hepatic veins, germinal membrane of the cyst extending into the IVC and right atrium. Enhanced CT: a giant hydatid cyst extending into the right atrium via the IVC, embolization of the cyst contents into the pulmonary arteries, near-complete occlusion of the lumen | Right atrium, IVC, left main and left lower lobe pulmonary arteries | Surgery and albendazole | Not mentioned |
| Abid et al (2011) []13 | 16/Male | Hemoptysis, chest pain, dyspnea | CT: distended distal branches of the right and left pulmonary artery, partial occlusion by cystic lesions and multiple segmental defects; an intra-right atrial mass; echocardiography: a large cystic mass measuring 19×22 mm, with a large implantation basis adhesive to the right side of the inter atrial septum with an extension to the right ventricle | Distal branches of the right and left pulmonary artery, right atrium and ventricle | Surgery: thora-cotomy, albenda-zole | After 18 months the patient is asympto-matic |
| Mahouachi et al (2007)[]14 | 51/Male | Hemoptysis, chest pain | Enhanced CT: multiple echinococcal cysts in both lungs and partial occlusion of a distal branches of the left pulmonary artery by cystic lesions, residual cavity in the liver | Distal branches of the right and left pulmonary artery | Albendazole | After 12 months the patient is asympto-matic |
| Savaş et al (2017) []15 | 48/Female | Dry cough, chest pain, dyspnea | Echocardiography: right chamber dilatation with moderate tricuspid regurgitation and elevated pulmonary artery systolic pressure (75 mmHg). Unenhanced CT: multiloculated cystic lesions in the pulmonary artery; a large filling defect by contrast-enhanced CT. MRI: multiloculated cystic lesions, hyperintense in T2-weighted images | Right pulmonary artery | Surgery: embolectomy | Dead |
| Asri H et al (2019) []16 | 73/Male | Dyspnea | Echocardiography: enlarged pulmonary arteries, enlarged chambers of the right heart and elevated pulmonary systolic pressure (80mmHg). CT: a cystic filling defect of the pulmonary artery | Main and right pulmonary artery | Albendazole | Not mentioned |
| CT – computer tomography; MRI – magnetic resonance imaging; CTA – computed tomography angiography; IVC – inferior vena cava. | ||||||