A rare case of cardiac alveolar echinococcosis without any complications for eight years
Makaleler > Tam Makale · 2021
Yazarlar: DİDEM ÇELİK, İLKER ÖDEMİŞ, Metin KORKMAZ, ŞÜKRAN KÖSE
Revista Española de Quimioterapia, SCI Expanded İndekslerine Giren Dergi, Uluslararası, Wos, 2021, cilt 35, ss 91-94
Özet
patient demonstrated multiple space-occupying cystic lesions, the largest of them was 2x5 cm, in the left gluteus maximus, adductor, vastus lateralis and vastus medialis muscles of the quadriceps femoris group (Figure 1a-1b).Depending on the radiological examination EM infection was considered.When the patient's anamnesis was questioned again in terms of EM, it was learned that he was living with his dog and has a history of eating steak tartar a la turca, unwashed raw vegetables and fruits.The indirect hemagglutination test (IHA) test result for hydatid cyst was 1/1280 and the western blotting was positive (Figure 2).The brain and liver appeared to be normal on the whole-body magnetic resonance imaging, which was performed for screening purposes.A 27×25 mm lesion with a slight thickness of hyperdense wall was detected in the posterior aspect of the cardiac interventricular septum (Figure 3) and multiple cystic lesions; the largest of which was 22×17 mm, were detected in the bilateral lung parenchyma (Figure 4).Heterogeneous, hypodense lesions, which are 2 cm in diameter and attached to the surrounding tissues, were detected in the anterior and postero-lateral aspects of the left psoas muscle.PNM system for classification of human alveolar echinococcosis was PXN1M1 (Stage IV), therefore the cyst in the cardiac interventricular septum was consulted to the Department of Cardiology and Cardiovascular Surgery, however medical therapy was preferred as the patient did not consent for cardiac surgery as the surgery might be life-threatening.Albendazole was ordered at a dose of 2×400 mg.The cyst compressing vena iliaca in the retroperitoneum was resected.In pathological examination of this cyst; a fibrous wall, 9x5x2.5 cm in size, containing adipose tissue areas on its outer surface, and a large number of cuticular membranes with the largest diameter of 4.5 cm and the smallest millimetric were observed.The cardiac magnetic resonance imaging performed after 3 months of medical therapy revealed regression in the size of the intracardiac cyst.On the 6th month and 1st-year control visits, no progression was determined in the size of cysts with no additional complaint.Furthermore no side effects were observed.