The medical team of the San Roque Sanatorium, in Curuzú Cuatiá, Corrientes, described the case of a 59-year-old patient who consulted due to a cough, showing a mass in the lower lobe of the right lung on imaging studies. There they found a tumor (sarcoma) coexisting with pulmonary hydatidosis (a disease caused by a parasite that usually lives in dogs).
The patient was not a smoker and, in addition to the cough, presented mucus expectoration of a month’s evolution.
The professionals recognized that pulmonary hydatid cyst is extremely rare and that they only found a similar case report published in 1970. That is, a similar case was reported more than 50 years ago.
However, In this region, hydatidosis continues to be frequent. and its pulmonary location is, together with the liver, the two most common forms of presentation.
The patient underwent surgery, confirming the impossibility of resection of the tumor during surgery. He was subsequently referred to oncology where it was decided to perform radiotherapy and chemotherapy, but passed away before starting them due to a cardiovascular complication.
The description of this case was made for the magazine “Medicina” (Buenos Aires). Miguel Penizzotto, Gabriela Robaina, María Elena Urdapilleta (Pulmonology Service), Mariela Retegui (Pathology Service), María Florencia Arrien Zucco and Christian Larralde (Diagnostic Imaging Service) from the San Roque Sanatorium participated in the case report.
extraordinary fact
The team considered, as a possible explanation for what happened, that this patient had a long-standing hydatid cyst, which has become complicated and, since it was not intervened and extracted in its initial stage, chronic inflammation has been generated that later led to sarcoma. The indicated treatment in both conditions is surgical resection, although the prognosis is poor, due to the high rate of local recurrence and distant spread.
In conclusion, although pulmonary hydatidosis is endemic in some areas of Argentina, its coexistence with cancer is an extraordinary fact and with sarcoma, in particular, even more so.
hydatidosis
Hydatidosis is a zoonosis caused by larval forms of helminths of the genus Echinococcus. It is transmitted by the dog through its fecal matter.. Elisa’s serologic test for the 59-year-old man was positive for Echinococcus.
The infection of this disease occurs when the eggs of the parasite reach the mouth of people and this occurs through activities such as: kissing the dog, letting the dog lick them, eating contaminated vegetables, drinking contaminated water, etc.
On examination of the patient’s chest, dullness was observed in the lower right lung field, with decreased breath sounds in that area.
The histopathology showed a high-grade sarcoma, without being able to typify its lineage with immunohistochemistry; The biopsies also revealed fragments of hydatid membranes, leading to the final diagnosis of pulmonary sarcoma associated with hydatidosis.
(IB)
