Complete extraction of a hydatid membrane by bronchial fibroscopy

Pulmonary hydatid cyst is exceptional in our country. The diagnosis is generally established on the basis of imaging. Surgical treatment is indicated in most patients. We report a case of pulmonary hydatid cyst in a 74-year-old smoker (11 package-years) who presented cough with mucopurulent expectoration and occasional hemoptysis. The chest x-ray demonstrated a poorly delimited heterogeneous opacity in the upper third of the left lung which persisted after antibiotic therapy. Bronchial fibroscopy revealed a hydatid membrane in the left superior bronchus which was totally removed by aspiration. A control radiography after the fibroscopy demonstrated a clear regression of the opacity. A thoracic CT-scan was performed and revealed a residual cavity in the left upper lobe with bronchial dilatation. The indication for surgery was not retained. Treatment of pulmonary hydatid cyst by endoscopy is an exceptional event. Our exceptional case illustrates an atypical radiological presentation and the use of "therapeutic" fibroscopy.