Case of the week 08-03: Primary Pericardial Echinococcosis

History: 47 year ♀ previously admitted with a severe pericardial effusion which was drained and an associated left pleural effusion. Subsequently referred for a CMR scan with as a structure “like a cyst” was noted near the heart on echocardiography.  CMR: Axial SSFP (see image) demonstrated a polycystic mass (7x9x6 cm) pressing on the lateral LV wall. Echinococcus Granularis antibody titre was significantly raised and subsequent whole body CT did not show any other evidence of hydatid disease. Perspective: Primary pericardial echinococcosis is a rare manifestation of the hydatid disease presenting either acutely as cardiac tamponade or with a more chronic indolent course as in this case. Treatment is albendazole or mebendazole followed by surgical removal.

Enrico Franzì, Salvatore di Stefano.Department of Cardiology, Hospital “San Vincenzo”, Taormina, Italy