Giant
hydatid cysts of the lung (diameter, ≥10 cm) are considered more difficult to treat surgically than are smaller
cysts. We reviewed our experience with giant
pulmonary hydatid cysts, focusing on clinical symptoms, cystic location, extent of surgery, and postoperative complications, according to age, long-term results, and comparison with non-giant
cysts. From January 1988 to January 2008, 537 patients underwent surgery for
pulmonary hydatid cysts. We separated patients into 2 groups: patients who had
cysts <10 cm (group A) and those who had giant
cysts (group B). Group B comprised 75 patients (14%). Giant
cysts were more common in younger patients (mean age, 30 vs 32 yr; P=0.014). The most frequent complaints were
cough,
chest pain, and
dyspnea. Patients with giant
cysts were more often symptomatic at presentation (96% vs 88%; P=0.04). In both groups, lower-lobe locations predominated. Parenchyma-saving operations were almost uniformly performed for each group; however, a higher percentage of patients in group B required anatomic resection (4% vs 1%; P=0.038). Fifty-seven patients (10%) also underwent resection of concomitant liver
cysts. Cystic
rupture occurred more frequently in group B than in group A (27% vs 15%; P=0.01). There were no deaths in either group, nor were there significant differences in morbidity between groups.In summary, giant
hydatid cysts of the lung occurred more often in younger patients and were more often symptomatic at presentation. Regardless of size, the
cysts could usually be surgically treated without lung resection, and size did not appear to influence short-term perioperative outcomes.