DIAPHRAGMATIC HYDATID CYST: DIAGNOSTIC CHALLENGE FOR A RARE PATHOLOGY

Hydatid disease mainly affect liver and lung. The incidence of diaphragmatic hydatid cysts, isolated or involving other organs, is very rare, accounting for 1% of the thoracic locations. They may be operative discovery or by their complication. Preoperative diagnosis of hydatid cysts located at the diaphragm is challenging. And surgery remains the only therapeutic approach. The prognosis is generally good apart from the risk of recurrence. We present a rare case of a 44-year-old female, with previous history of liver hydatidosis, who presented to our attention with right hypochondrium pain with fever. The diagnosis was fortuitous during the surgical exploration, while preoperatively, CT scan showed a cyst apparently located on segment VIII of the liver, and announced the hypothesis of fistula between this cyst and the lung. After imagistic investigations we decided for an abdominal approach considering that the cyst was liver related. But after dissection of the adherences with the liver, the cyst remained attached to the diaphragm.  The treatment of choice was surgical removal of the cyst. And the patient is now being closely followed up.