Enfermedad hidática diseminada con localización mediastinal como causa de síndrome de vena cava superior / Disseminated hydatidic illness with mediastinal location causing superior cave syndrome

RESUMO

Hydatidic illness is a frequent parasitic zoonosis in our country whose more frequent localization is the liver and the lungs. However other many sites have been described, depending their symptoms on the cyst's size, localization and effect on next structures, being sometimes its evolution fatal. This is a 52 year-oldfemale patient admitted at emergency room for dysfunction of sensory and neurological localization. She had a previous history of surgery many years ago by abdominal tumor. We found a collateal circulation on right hemithorax and facial arms edema at exam. The cerebral CT showed extensive left parietal parenchymal hemorrhage. Thoracoabdominal CT revealed multiple cystic masses of diverse sizes in the mediastinum, lungs, liver and other places. The patient's evolution was torpid, theneurological compromise didn't improve in spite of the treatment against the intracranial hypertension (EH), being also adde a nosocomial pneumonia. The patient died after several days. Necropsy revealed presence of cystic lesions in mediastinum, heart's great vessels, pericadium, lungs, liver, spleen and omentum, as well as intra and extraparenchymal hemorrhages of hipertensive cause in brain, not beig cystic lesions in central nervous system. We concluded that it was disseminated hydatidic illnes, cysts in themediastinum caused comprenssion of the heart's great vessels, causing a superior cave vin syndrome.