Huge Intramyocardial Echinococcal Cyst Resulting in a Significant Left Ventricular Cavity Obliteration Evaluated by Real-Time 3-Dimensional Transesophageal Echocardiography and Multidetector Computed Tomography Before and After Complete Excision

A 13-year-old girl was referred to our hospital with symptoms of dyspnea, palpitations, and faintness. Physical examination was normal and chest x-ray (Figure 1) showed marked cardiomegaly, and an ECG showed T-wave inversion at the D1 and aVL leads. However, transthoracic echocardiography disclosed an echo-free and cystic structure 6 cm in diameter located within the posterolateral myocardial wall segments of the left ventricle and resulting in significant cavity obliteration (Figure-2). Two-dimensional transesophageal echocardiography (TEE; Movie I in the online-only Data Supplement) and real-time 3-dimensional TEE (Movie II in the online-only Data Supplement) confirmed the spherical appearance and thick walls of this huge intramyocardial structure …