Intrathoracic Echinococcosis: A 5-Year, Single-Center Experience

Human cystic echinococcosis (CE) is caused by the larval forms of Echinococcus granulosus s.l. species complex that mainly affect the liver, with lung as the second most frequent location. We describe our experience with surgical treatment of lung CE, emphasizing the need for the least invasive approach when possible. Patients with intrathoracic CE who accessed our center from January 2019 to November 2023 were reviewed. Twenty-two patients, 12 males (54.5%), mean age 35 years, range 9-60, were treated. Eight patients (36.4%) had only lung involvement, seven (31.8%) had both liver and lung involvement, and seven (31.8%) had other locations. Thoracic surgery was required for large dimensions or pain (six each), hemoptysis (four each), skin fistulization and pericardial involvement (two each), and infection and emission of parasitic material by cough (one). A minimally invasive video-assisted thoracic surgery approach was used for 12 (54.5%) patients, whereas 10 underwent anterior thoracotomy. Three patients underwent sequential lung and hepatic surgery in a single session, one with myocardial wall involvement underwent thoracic and cardiac surgery in a single session. All patients received albendazole before and during surgery. There was no operative and postoperative mortality. The mean follow-up was 11.5 months (range 1-30). Patients with intrathoracic CE may present with acute and even life-threatening symptoms and should be managed preferably with tissue-sparing surgery by a multidisciplinary team in a referral center.