Primary Isolated extraluminal Hydatid Cyst of Left Pulmonary Artery Mimicking COVID-19 Infection (preprint)

Hydatid cyst of pulmonary artery is extremely rare. There were few reports of intramural involvement of pulmonary artery secondary to cardiac or lung hydatic cyst in literature. To the best of our knowledge there was no report of primary isolated extraluminal hydatid cyst of left pulmonary artery. A twenty-eight–year-old female presented to the hospital with complaint of progressive dyspnea. The patients had no common COVID-19 infection symptoms. The RT-PCR for COVID-19 RNA was negative. Spiral chest CT-scan demonstrated a cystic mass sized 83×34 in middle mediastinum. Intraoperatively, the intrapericardial mass arising from left pulmonary artery and extended to the hilum of left atrium. The mass was resected and pathology report noted a hydatid cyst. The postoperative course was uneventful and the patient was discharged with administration of albendazol for 3 months. However hydatid cyst primary isolated extraluminal hydatid cyst of pulmonary artery are extremely rare, in cases with pulmonary artery stenos or hypertension manifestation should be considered as a probable differential diagnoses. Regarding to ongoing COVID-19 pandemic the present case misdiagnosed with coronavirus infection.

Cardiac Metastasis from Gastric Adenocarcinoma Mimicking COVID-19 Symptoms (preprint)

Background Cardiac metastasis with origin of gastric adenocarcinoma is extremely rare. This type of metastasis tends to involve the pericardium through lymphatic seeding. Currently, no reports of solitary tumor emboli to the heart cavity with possible transvenous pathway of seeding has been made. Due to initial dyspnea and accompanying symptoms, cardiac tumor embli may be mistaken with covid-19 infection.Case presentation: A sixty-year-old female with known inoperable diffuse gastric adenocarcinoma receiving chemotherapy from eight months ago, presented to hospital with progressive dyspnea. Other sign and symptoms included chest pain, hypotension, tachycardia and muffled heart sounds. The patients had no fever or other common covid-19 infection symptoms. The RT-PCR for Covid-19 RNA was negative. Initial chest CT-scan showed no sign of infection. A transesophageal echocardiography was performed and revealed a > 6cm vermiform mass free-floating in the right atrium protruding to the tricuspid valve and right ventricle compatible with emboli. By urgent cardiac surgery the mass was removed. The postoperative course was uneventful. The pathology results confirmed a tumor emboli originated from gastric carcinoma. Whole body PET-scan shoed no evidence of other metastasis.Conclusions However cardiac metastasis are extremely rare, in gastric cancer cases with cardiopulmonary manifestation should be considered as a probable differential diagnoses. Regarding to ongoing covid-19 pandemic the present case misdiagnosed with coronavirus infection.