Diaphragmatic hydatid disease: a diagnostic challenge for the radiologist

##plugins.themes.academic_pro.article.main##

Hichem Jerraya
Ali Gaja
Mehdi Khalfallah
Chadli Dziri

Abstract


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.


##plugins.themes.academic_pro.article.details##

References

  1. Kabiri H, Al Aziz S, El Maslout A, Benosman A. Diaphragmatic hydatidosis: Report of a series of 27 cases. Rev Pneumol Clin. 2001; 57: 13-9.
  2. Makni A, Fetirich F, Jouini M, Kacem M, Ben Safta Z. Primary and isolated phrenic hydatid cyst in Tunisia. Bull Soc Pathol Exot. 2012; 105: 262-4.
  3. OÄŸuzkaya F, Akçali Y, Kahraman C, EmiroÄŸullari N, Bilgin M, Sahin A. Unusually located hydatid cysts: intrathoracic but extrapulmonary. Ann Thorac Surg. 1997; 64: 334-7.
  4. Kim MP, Hofstetter WL. Tumors of the diaphragm. Thorac Surg Clin. 2009; 19: 521-9.
  5. Chavhan GB, Babyn PS, Cohen RA, Langer JC. Multimodality imaging of the pediatric diaphragm: anatomy and pathologic conditions. Radiographics. 2010; 30: 1797-817.
  6. Akinci D, Akhan O, Ozmen M, Ozkan OS, Karcaaltincaba M. Diaphragmatic mesothelial cysts in children: radiologic findings and percutaneous ethanol sclerotherapy. AJR Am J Roentgenol. 2005; 185: 873-7.
  7. Marrone G, Crino' F, Caruso S, Mamone G, Carollo V, Milazzo M et al. Multidisciplinary imaging of liver hydatidosis. World J Gastroenterol. 2012 ;18: 1438-47.
  8. Eren S, Ulku R, Tanrikulu AC, Eren MN. Primary giant hydatid cyst of the diaphragm. Ann Thorac Cardiovasc Surg. 2004; 10: 118-9.