A 38-year-old woman with type II diabetes mellitus treated with oral hypoglycemic agents.
Natural from Temuco city (Chile, IX Region) where he lived up to 25 years old, having habitual contact with canines.
Located to Santiago where he continues living with domestic animals.
She presented at the otorhinolaryngology polyclinic with a 20-month history of progressive and painful swelling in the right lateral region of the neck, with dyspnea on great efforts and occasional illogical dysphagia.
Physical examination revealed a fluctuating and slightly painful increase in right cervical volume due to palpation.
A neck TAC was requested, as well as a supra and infraclavicular mass of approximately 5 cm in diameter, with multiple septa inside, which compromised caudally, posterior mediastinum and right middle mediastinum, extending superiorly to the region.
It was concluded that it was compatible with the existence of non-casual loans.
The study was complemented with a 5-cm cystic image showing in the middle and posterior areas that did not capture a medium of 5 cm, its major axis, adjacent to the mediastinum cefa to the thorax, in its caudal part and
In addition, the examination showed some bilateral interstitial lung images, larger to the left, associated with residual bullae.
Lymph nodes were not visualized.
It was concluded in this examination that the image was compatible with a mediastinal tumor with cervical extension, of unknown nature.
The patient was referred to the Thoracic Surgery Unit for definitive treatment.
Preoperative exams showed leukocytes of 5,000 cells/mm3, with 2% eosinophils, hematocrit of 40.3%, hemoglobin 14.1 mg/dl, normal renal function tests, normal prothrombinemia and normal electrocardiogram.g.
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The patient was managed by visualizing a right lateral vein logging a mediastinal multinodal tumor that ranged from the base of the neck to the level of the neck.
Sample collection for intraoperative rapid biopsy showed membranes, liquid and daughter vesicles typical of HQ that were removed and aspirated.
Total pericystectomy was then performed instilling 3% hypertonic saline solution into the residual cavities.
The lungs and bladder had normal macroscopic appearance.
The result of the intraoperative and delayed rapid biopsy confirmed the diagnosis of multivesicular HQ.
In the postoperative period he presented a right basal pneumonia that was treated empirically with ceftriaxone with satisfactory results.
She was discharged in good condition and maintained in periodic controls at the specialty polyclinic.
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A new CT scan of the chest was performed seven months after the operation and showed no disease.
Two years after surgery, the patient remains under control and follow-up.
It remains asymptomatic and without clinical and radiological evidence of recurrence or location of HQ in other target organs.
