Hydatid cyst of anterior mediastinum

INTRODUCTION: Echinococcosis is endemic in Romania. Hydatid cyst can develop in any segment or organ, but the most frequent locations are liver and lung. Mediastinal hydatid lesions are extremly rare and only a few cases exists in the medical literature. MATERIAL AND METHOD: Between 1994 and 2011 Thoracic Surgery Clinic, UMF "Carol Davila" there were 3 patients diagnosed and surgical trated for hydatid cyst of mediastinum. The patients were 2 men and 1 woman aged of 20, 37 and 52 years. All hydatid cysts were located in the anterior mediastinum and all were solitary lesions when diagnosed. RESULTS: In 1 case the positive diagnosis was made preoperatively, in the other 2 the diagnosis was intraoperative. The approach was through thoracotomy. One cyst was complicated (nonviable thymic hydatid cyst), treated by ideal cystectomy, and 2 cysts were viable. There was 1 postoperative complication: gaseous cerebral embolism remitted after medical treatment, caused by the intraoperative use of H2O2 as scolicide agent. CONCLUSIONS: Although very rare, anterior mediastinal hydatid cysts must be considered in every patient with anterior mediastinal mass. Complete surgical excision is the treatment of choice; surgery followed by parasiticide therapy provides complete cure.