[Echinococcal hydatid cyst in the right ventricle].

HISTORY AND CLINICAL FINDINGS: A 32-year-old man of Albanian descent had for ten years been complaining of pain over the apex of the heart with gradually increasing dyspnoea. He was hospitalised because of an acute duodenal ulcer.

INVESTIGATIONS: Clinical and biochemical examinations were within normal limits. Computed tomography and magnetic resonance imaging revealed a myocardial tumour in the right ventricle, 4 x 3 x 3 cm.

TREATMENT AND COURSE: A primary myocardial tumour of unknown malignancy was suspected, but at surgery it was found to be an echinococcal cyst, which was resected. Echinococcal antigen titre, first measured postoperatively, was positive (ELISA and IHA tests). Albendazole was administered (50 mg/kg daily) to prevent recurrence. The patient was still symptom-free two years postoperatively.

CONCLUSION

Echinococcal cyst should be considered in the differential diagnosis of cardiac tumour. If untreated the condition may be fatal. Resection under cardiopulmonary bypass with cardioplegia, as in this patient, carries a low risk and is therefore the treatment of choice.