[Giant hepatic echinococcus cyst with cysto-pleural fistula and pleural echinococcosis].

Extrahepatic complications from hepatic cystic echinococcosis are rare and may be life threatening. Although the prevalence of echinococcosis in Spain had decreased, the number of cases of this disease and its severity has risen again due to immigration. We report the case of a patient with a giant hepatic echinococcus cyst diagnosed during investigation of an abdominal mass. The mass was associated with three other cysts: the first cyst was fistulized to the biliary tract, without clinical or laboratory alterations, the second cyst was fistulized to the right pleural cavity, leading to pleural echinococcosis and respiratory distress due to massive pleural effusion, and the third cyst was calcified. The challenge in this case layed in its diagnosis and treatment. The clinical presentation was unusual due to the extension of the disease, hampering complete cystic excision.