Methods: Between June 1997 and January 2008, 104 patients were operated on for hydatid cysts of the lungs. Twenty of these patients (12 boys, 8 girls; mean age 12.4 years; range 6 to 15 years) in whom cysts measured above 10 cm in any diameter and who were in the pediatric age group were retrospectively evaluated. The main complaints in all cases were nonspecific respiratory symptoms such as dry cough, chest pain and weakness. Chest computed tomography was the most specific diagnostic modality.
Results: Giant hydatid cysts were mostly observed in the right lung. Muscle sparing thoracotomy was performed in all cases. Procedures included cystotomy-capitonage in 14 (70%) patients, cystotomy in five (25%) patients and enucleation in one (5%). There was no operative mortality, but complications were observed in five (25%) patients; prolonged air leak in three cases, and pneumonia and pleural empyema in one case each. In one patient with an air leak beyond 10 days, re-thoracotomy was performed with favorable outcome.
Conclusion: The treatment of choice for giant hydatic cyst disease of the lungs in childhood is surgery. Though the possibility of postoperative complications is greater than for simple cysts of the lungs, the benefits of surgical treatment remain high.