Case Presentation:
A 10-year-old male patient was evaluated in another center with a
complaint of headache that started nine months ago. The cranial magnetic
resonance imaging (MRI) examination showed multiple cystic lesions. The
results of the serological tests were negative. Surgical treatment was
performed, and intraoperative evaluation was compatible with HCD. The
patient was referred to our clinic for treatment planning upon detecting
transthoracic echocardiography (TTE) findings consistent with a CHC
lesion in the left ventricular apex.
In the first evaluation, there were no pathological signs in the
patient’s neurological, abdominal, pulmonary, and cardiac physical
examinations. Since bilateral lower extremity pulses could not be
palpated, aorta-lower extremity computed tomographic angiography imaging
(CTA) was performed in addition to cranial, abdominal, and cardiac(MRI).
In the cranial MRI, a contrasting multiple hydatid cyst lesion was
observed in the bilateral cerebral hemispheres, which was smaller than
in the previous MRI. CTA of the aorta and lower extremities showed
occluded abdominal aorta and iliac arteries in a 5 cm segment. Femoral
arteries were filling with collaterals. On cardiac MRI, the hydatid cyst
lesion at the apex of the left ventricle (LV) was seen as opening into
the ventricle and causing aneurysmatic dilatation in the
myocardium.[Figure 1]
The patient’s occlusion of the abdominal aorta was compatible with
systemic embolism due to a ruptured CHC. No other organ involvement was
observed in the radiological evaluation. The only data we have regarding
the etiology is that the patient had a brief history of feeding a stray
cat at home two years ago. The patient was surgically repaired with the
Dor procedure (aneurysmectomy and circular endoventricular patch
plasty). [Figure 2]The postoperative period was uneventful. The
patient was followed up regularly for five years by the local
cardiovascular surgeon in coordination with our clinic.