Hydatid disease of the ribs: a diagnostic challenge with an endless differential diagnosis – a case report

Hydatid disease is a parasitic infection in humans caused by Echinococcus granulosus and can lead to tissue cyst formation anywhere in the body. The most common sites for the development of parasitic cysts are the liver (75%) and lungs (15%). Skeletal involvement in echinococcal infection is relatively rare, occurring in only 1%–4% of cases. Few reports in the available medical literature describe rib hydatidosis, which clinically mimics benign or malignant cystic tumors. We present the case of a 73-year-old female patient who underwent multiple surgeries for pulmonary and hepatic echinococcosis. She was treated with albendazole (800 mg daily) and underwent computed tomography, which revealed cystic formations in the chest wall, including lysis of a thoracic vertebra and adjacent rib arches, interpreted in the differential diagnosis as pulmonary carcinoma or pleural mesothelioma. Surgery facilitated both diagnosis and treatment. Six months postoperatively, no recurrence in the chest wall was observed. Hydatid cysts occurring in the chest wall are rare and should be included in the differential diagnosis of chest wall formations, particularly in endemic areas and in patients with a history of hydatid disease.