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Objective: The aim of this study was to determine the problems in diagnosis and management of patients over 50 with pulmonary hydatid cysts.
Design: We evaluated 40 patients over 50 years with hydatid disease of lung who were operated in our hospital in 1988-1999- Setting: SSK Süreyyapaşa Center for Chest Diseases and Thoracic Surgery Clinics.
Patients: In this retrospective study, forty patients (23 male, 17 female) aged between 50 to 71 years were evaluated (mean 56.5). 24 of these had the cyst in the right lung, where 13 had the cyst in the left lung and 3 had the cyst bilaterally.
Interventions: Radiologically, 17 patients (42.5%) had typical, the remaining 23 (57.5%) had atypical cysts. 11 of the atypical cyst patients had bronchoscopic evaluation and four of them had the definitive diagnosis histopathologically. Abdominal ultrasonographic evaluation revealed that 14 of 29 patients had the cyst in the liver and in addition to the liver one cyst in the kidney, spleen, adnexa, extrapulmonary tissue and pericardium. The operation procedures were 28 cystostomy, 12 cystostomy and removal of surrounding lung tissue.
Measurements and Results: We evaluated diagnostic tests, types of operations, recurrence, mortality and morbidity rates of the patients. There were no operative deaths (mortality: 0%), and postoperative complications occurred in seven patients (morbidity: 17.5%). Mean duration of hospital stay was 13 days in nonmorbid, and 39 days in morbid patients. Radiological imaging gave a correct diagnosis in 42.5% of the patients. The Casoni and Weinberg tests were positive in 83% of the cases, while eosinophilia was present in 22%. The recurrence rate was 10%. In 48% of the patients hydatid cysts were concomitant in lung and liver.
Conclusion: We should always keep hydatid cyst in mind in elderly patients with atypical radiology and should use serological tests preoperatively. Regardless of age, patients should be operated.