Pulmonary hydatidosis mimicking metastatic malignancy

Scattered pulmonary nodules are usually highly suspicious of metastatic malignancy, but can be one of radiological presentations of some infectious diseases such as hydatidosis. In order to analyse particularities of pulmonary hydatidosis mimicking metastatic malignancy, we report 5 cases of patients hospitalized in the pulmonary department of the Tunis Chest Disease and Surgery Training Hospital. The average age was between 36 and 74 years. The clinical features were dominated by haemoptysis (4 cases) and cough (2 cases). Chest radiograph showed disseminated pulmonary opacities in all cases. CT scan of the chest was helpful for diagnosis. Fibreoptic endoscopy performed in all cases showed hydatic membrane and confirmed the diagnosis in 2 patients. Investigation ELISA for Echinococcus was positive in all cases. Four patients had pulmonary embolic hydatidosis due to the involvement of right cardiac cavities. One patient had bronchogenic hydatidosis due to the rupture of pulmonary cysts into bronchi. Medical treatment (albendazole) was performed in all patients associated with surgical treatment in 2 cases. After treatment, 2 cases of recurrence were noted. Disseminated pulmonary hydatidosis may present diagnosis difficulties particularly with metastatic malignancy. Its management is difficult and costly.