Autopsy and Case Reports
https://autopsyandcasereports.org/article/doi/10.4322/acr.2024.501
Autopsy and Case Reports
Autopsy Case Report

Incidental finding of cardiac hydatid cyst during autopsy

Nishant Purbey; Amit Patil; Shreekant Bharti; Keshav Chandra; Shashank Ranjan

Downloads: 2
Views: 295

Abstract

Hydatidosis or echinococcosis is an endemic parasitic disease caused by the ingestion of eggs of echinococcal species worldwide. In India, the annual incidence varies from 1 to 200 per one 100,000 hab., with the highest prevalence reported in the Indian states of Andhra Pradesh and Tamil Nadu. The dog is the definitive host, while humans, sheep, and cattle are intermediate hosts. The disease usually involves the liver and lungs, with the kidney and other organs rare involvement. Cardiac hydatidosis is still further rare, seen in 0.2% to 2% of the patients who remain asymptomatic until the development of its complications. Sudden deaths in cardiac echinococcosis are mostly attributed to cardiac arrhythmias, coronary artery diseases, valvular diseases, cardiomyopathies, pericarditis, and cardiac tamponade. We, herein, report a rare case of cardiac hydatid cyst incidentally found during the autopsy of a 26-year-old male who died due to electrical injuries. A single greyish-white cystic mass measuring 1.5cm X 1.2cm was detected on the left anterior ventricular wall 4 cm above the apex and was confirmed microscopically as a hydatid cyst. The cause of death was attributed to external injury.

Keywords

Echinococcus, Electric Injuries, Parasitic diseases, Autopsy, Forensic Pathology

References

1 Gun E, Etit D, Buyuktalanci DO, Cakalagaoglu F. Unusual locations of hydatid disease: a 10-year experience from a tertiary reference center in Western Turkey. Ann Diagn Pathol. 2017;29:37-40. http://doi.org/10.1016/j.anndiagpath.2017.01.011. PMid:28807340.

2 Parija SC. A textbook of medical parasitology. 2nd ed. Madras: All India Publishers and Distributors; 2004. p. 220-9.

3 Reddy CR, Narasiah IL, Parvathi G, Rao MS. Epidemiology of hydatid disease in Kurnnol. Indian J Med Res. 1968;56(8):1205-20. PMid:5751850.

4 Amir-Jahed AK, Fardin R, Farzad A, Bakshandeh K. Clinical echinococcosis. Ann Surg. 1975;182(5):541-6. http://doi.org/10.1097/00000658-197511000-00001. PMid:1190858.

5 Mathur PN, Parihar S, Joshi CP, Kumawat JL. Hydatid disease-still endemic in the southern region of state of Rajasthan, India: a clinical study carried out in tertiary care hospital. Int Surg J. 2016;3(4):1802-5. http://doi.org/10.18203/2349-2902.isj20162814.

6 Vecchio R, Vecchio V, Intagliata E. Transmission ways of Echinococcus granulosus in rare muscular locations of hydatid disease. Ann Med Surg (Lond). 2020;55:332-3. http://doi.org/10.1016/j.amsu.2020.04.047. PMid:32566219.

7 Alexander J, Sharpe MH, eds. Infectious diseases. In: Cotran RS, Kumar V, Robbins SI. Robbins pathologic basis of disease. Philadelphia, PA: Saunders Elsevier; 2010. p. 331-98.

8 Büyük Y, Turan AA, Uzün I, Aybar Y, Cin O, Kurnaz G. Non-ruptured hydatid cyst can lead to death by spread of cyst content into bloodstream: an autopsy case. Eur J Gastroenterol Hepatol. 2005;17(6):671-3. http://doi.org/10.1097/00042737-200506000-00013. PMid:15879731.

9 Farris AB, Petur Nielsen G. Genitourinary infectious diseases pathology. In: Kralin RL, editor. Diagnostic pathology of infectious diseases. Philadelphia, PA: Elsevier; 2010. p. 429-67.

10 Chadly A, Krimi S, Mghirbi T. Cardiac hydatid cyst rupture as cause of death. Am J Forensic Med Pathol. 2004;25(3):262-4. http://doi.org/10.1097/01.paf.0000136443.46066.dc. PMid:15322472.

11 Sahin I, Ozkaynak B, Ayca B, Okuyan E. An uncommon localization of a giant hydatid cyst presenting with cardiac tamponade. Turk Kardiyol Dern Ars. 2015;43(1):86-8. http://doi.org/10.5543/tkda.2015.59207. PMid:25655857.

12 Johnstone MT, Notariani M, Charlamb M. Images in cardiovascular medicine: ventricular tachycardia as a complication of an intramyocardial echinococcal cyst. Circulation. 2000;102(1):123-5. http://doi.org/10.1161/01.CIR.102.1.123. PMid:10880425.

13 Hosseini M, Hedjazi A, Bahrami R. Sudden death due to anaphylactic shock in a patient with an intact hepatic hydatid cyst. Am J Forensic Med Pathol. 2014;35(4):256-7. http://doi.org/10.1097/PAF.0000000000000128. PMid:25340647.

14 Banisefid E, Baghernezhad K, Beheshti R, et al. Cardiac hydatid disease; a systematic review. BMC Infect Dis. 2023;23(1):600. http://doi.org/10.1186/s12879-023-08576-3. PMid:37705012.

15 Malamou-Mitsi V, Pappa L, Vougiouklakis T, et al. Sudden death due to an unrecognized cardiac hydatid cyst. J Forensic Sci. 2002;47(5):1062-4. http://doi.org/10.1520/JFS15520J. PMid:12353547.

16 Ben-Hamda K, Maatouk F, Ben-Farhat M, et al. Eighteen year experience with echinococcosus of the heart: clinical and echocardiographic features in 14 patients. Int J Cardiol. 2003;91(2-3):145-51. http://doi.org/10.1016/S0167-5273(03)00032-9. PMid:14559124.

17 Tuncer E, Tas SG, Mataraci I, et al. Surgical treatment of cardiac hydatid disease in 13 patients. Tex Heart Inst J. 2010;37(2):189-93. PMid:20401292.

18 Di Bello R, Menendez H. Intracardiac rupture of hydatid cysts of the heart. A study based on three personal observations and 101 cases in the world literature. Circulation. 1963;27(3):366-74. http://doi.org/10.1161/01.CIR.27.3.366. PMid:14027496.

19 Seth HS, Mishra P, Khandekar JV, Raut C, Mohapatra CKR, Ammannaya GKK. A concomitant intramyocardial and pulmonary hydatid cyst: a rare case report. Rev Bras Cir Cardiovasc. 2017;32(2):138-40. http://doi.org/10.21470/1678-9741-2016-0046. PMid:28492796.

20 Demircan A, Keles A, Kahveci FO, Tulmac M, Ozsarac M. Cardiac tamponade via a fistula to the pericardium from a hydatid cyst: case report and review of the literature. J Emerg Med. 2010;38(5):582-6. http://doi.org/10.1016/j.jemermed.2007.07.017. PMid:18065186.

21 Oraha AY, Faqe DA, Kadoura M, Kakamad FH, Yaldo FF, Aziz SQ. Cardiac hydatid cysts; presentation and management. A case series. Ann Med Surg (Lond). 2018;30:18-21. http://doi.org/10.1016/j.amsu.2018.04.001. PMid:29946454.

22 Mesrati MA, Mahjoub Y, Ben Abdejlil N, et al. Case Report: sudden death related to unrecognized cardiac hydatid cyst. F1000 Res. 2020;9:286. http://doi.org/10.12688/f1000research.23277.1. PMid:33500772.

23 Parvizi R, Namdar H, Bilehjani E, Bayat A, Sheikhalizadeh MA. Simultaneous operation of hydatid cyst of the heart and liver: a case report. J Cardiovasc Thorac Res. 2013;5(3):127-8. http://doi.org/10.5681/jcvtr.2013.027. PMid:24252990.

24 Bektas S, Erdogan NY, Sahin G, Kir G, Adas G. Clinicopathological findings of hydatid cyst disease: a retrospective analysis. Ann Clin Pathol. 2016;4(3):1071. http://doi.org/10.47739/2373-9282/1071.

25 Byard RW, Bourne AJ. Cardiac echinococcosis with fatal intracerebral embolism. Arch Dis Child. 1991;66(1):155-6. http://doi.org/10.1136/adc.66.1.155. PMid:1994846.

26 Byard RW. An analysis of possible mechanisms of unexpected death occurring in hydatid disease (echinococcosis). J Forensic Sci. 2009;54(4):919-22. http://doi.org/10.1111/j.1556-4029.2009.01065.x. PMid:19467137.

27 Mahjoub Y, Boussaid M, Mesrati MA, et al. Hydatid disease, an uncommon etiology of death in forensic practice. Am J Forensic Med Pathol. 2022;43(2):121-5. http://doi.org/10.1097/PAF.0000000000000750. PMid:35213407.

28 Pakis I, Akyildiz EU, Karayel F, et al. Sudden death due to an unrecognized cardiac hydatid cyst: three medicolegal autopsy cases. J Forensic Sci. 2006;51(2):400-2. http://doi.org/10.1111/j.1556-4029.2006.00056.x. PMid:16566779.
 


Submitted date:
11/18/2023

Accepted date:
05/01/2024

Publication date:
06/21/2024

667573efa953954b07379785 autopsy Articles
Links & Downloads

Autops Case Rep

Share this page
Page Sections