title: Aggressive hydatid cysts: characteristics of six cases.
abstract: OBJECTIVE
  Hydatid cyst (HC) disease is a zoonotic disease caused by the larvae of Echinococcus granulosus. We report our experience of treating HC manifesting aggressive characteristics.
  
  
  METHODS
  Between January, 2010 and December, 2013, 40 patients underwent surgery for HC disease in our department. The subjects of this study were six patients whose disease followed an aggressive and invasive clinical course. The HC disease in these patients involved the vertebrae, chest wall, mediastinum, diaphragm, and lung, with destruction of the lung.
  
  
  RESULTS
  There were four men and two women, with a mean age of 47 years (range 12-81 years). Treatment consisted of cystectomy and additional procedures, such as corpectomy and resection of the chest wall, approaching the liver and spleen with phrenotomy and lobectomy. One patient suffered prolonged biliary drainage, and another had a bronchopleural fistula and atelectasis. One patient died of empyema 1 month postoperatively. The mean hospital stay was 9 days.
  
  
  CONCLUSIONS
  In some patients, HCs can act as an aggressive tumor, involving the surrounding tissues, organs, and even bony structures. Aggressive HCs may cause various sequelae and require extended surgical interventions in addition to cystectomy.
authors.affiliation: Department of Thoracic Surgery, Afyon Kocatepe University School of Medicine, 03200, Afyonkarahisar, Turkey, gurhanoz_06@hotmail.com.
authors.forename: Gürhan
authors.initials: G
authors.lastname: Oz
authors.forename: Mehmet
authors.initials: M
authors.lastname: Eroglu
authors.forename: Ersin
authors.initials: E
authors.lastname: Gunay
authors.forename: Ahmet
authors.initials: A
authors.lastname: Bal
authors.forename: Emre
authors.initials: E
authors.lastname: Kacar
authors.forename: Olcay
authors.initials: O
authors.lastname: Eser
authors.forename: Okan
authors.initials: O
authors.lastname: Solak
mesh_terms: D000328:Adult; D000369:Aged, 80 and over; D002648:Child; D018450:Disease Progression; D004443:Echinococcosis / Q000175:diagnosis* / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index