Case Presentation:
The patient is a twenty-eight-year-old woman with a history of dyspnea and shortness of breath for the last month. During this period, she experienced shortness of breath when engaged in routine activities, chest discomfort and fatigue. She did not mention any symptoms of cough, nausea, vomiting, diarrhea and fever, and no direct contact with a coronavirus-infected person. Additionally, in the last two weeks, she went to a hospital in her city of residence and echocardiography was conducted for her which, according to her, did not have any remarkable findings. However, after two weeks, not only the symptoms did not improve, but they deteriorated. She presented to our hospital for more investigations. She had no history of previous surgery or hospitalization, though she was on Losartan for controlling her chronic hypertension since five months ago. In primary examinations, heart and lung auscultation were normal and the vital signs included respiratory rate = 22 per minute, pulse rate = 102 per minute, blood pressure 150/100 mm Hg, O2 saturation = 97%, and temperature = 36.8°C.
Regarding to ongoing COVID-19 outbreak, the COVID-19 RT-PCR test was requested for her and the result was negative.
Spiral chest computed tomography demonstrated 83×34 mm cystic lesion in middle mediastinal juxta pericardial with thick wall anterior to the left pulmonary artery. (Figure 1, LPA) In Interaoperative observation, the cystic mass arising from left pulmonary artery extended to left atrium hilum and caused compression on left pulmonary artery were observed (Video1, LPA). The mass was resected and sent to laboratory for culture and pathology investigations. The histopathological assessment demonstrated a hydatid cyst.
The postoperative course was uneventful and the patient was discharged with administration of albendazol for 3 months. Three month later in the postoperative follow-up visit, the patient stated no complaints.