Recurrence of Primary Pulmonary Hydatidosis in the Left Lung with No Hepatic Involvement

Echinococcus granulosus is the most common cause of hydatid disease of the lung. Hydatid disease is endemic to the Mediterranean countries, Middle East, South America and Australia. After liver, lung is the 2nd most common organ involved in this disease.1 The main route of infection is infestation of the embryo which after passing through the duodenal wall enters into the portal vein or the peri duodenal and perigastric lymphatics. The pulmonary cysts develop through this route, secondary to hepatic lesions. 1 Pulmonary hydatidosis is most commonly seen in men during the 2nd and 3rd decades of life. An intact cyst can be defined as “simple or closed cyst”, and a ruptured and / or infected cyst“ can be defined as “complicated cyst”.2 Recurrence has been defined as new active cysts appearing after therapy, which includes reappearance with continual growth of live cysts at the site of a previously treated cyst or new distant disease appearing as a result of spillage.3 The diagnosis of hydatid cyst diagnosis is often delayed because patients are asymptomatic for years during the period of growth of the parasite.2 Surgical goals in a case of hydatid cyst are: A - total eradication of the parasite; B - the prevention of the cyst 's rupturing on the operative field and its consequent dissemination; and C - the extirpation of the residual cavity.4 In this article, we report a rare case of male patient with multiple daughter cysts in the left lung at pleura-parenchymal junction and mediastinum who presented to us with recurrent pulmonary hydatidosis, which has caused complication of expectoration of multiple daughter cyst of small size.