Massive bilateral pulmonary hydatid disease in a seronegative child: Thoracoscopic management of an unusual presentation.

Pulmonary hydatid disease is uncommon in children and may present diagnostic difficulties, particularly when serology is negative. We report a 10-year-old boy from an endemic rural area who was incidentally found to have three giant pulmonary cysts involving both lungs. Despite negative Echinococcus serology, radiologic features were highly suggestive of hydatid disease. The patient underwent staged bilateral thoracoscopic endocystectomy with capitonnage following albendazole therapy. Histopathology confirmed the diagnosis. Postoperative recovery was uneventful, with complete radiological resolution and no recurrence at three-year follow-up. This case highlights the limitations of serology in isolated pulmonary hydatid disease and supports thoracoscopic lung-preserving surgery as an effective treatment in children.