Cardiac echinococcosis with negative serologies: a report of two cases.

Cardiac involvement in hydatid cyst disease is uncommon, occurring in approximately 2% of hydatid cases. Two cases of cardiac hydatid cysts with negative serologic tests are reported herein. In Case 1, the patient underwent surgery to remove cysts from the liver and 10 years later presented with symptoms and signs of ischaemic heart disease. In Case 2, the patient first underwent surgery to remove cysts from the brain and 3 years later for cyst removal from the breast. In both cases the diagnosis was established by transthoracic two-dimensional echocardiography and then confirmed by surgery and histological examination. These cases are of particular interest because of the rarity of cardiac localisation as a new site of the hydatid cyst after one or more previous surgeries for hydatid cyst removal, and stress the need for frequent reevaluation to detect new hydatid cyst formation in the heart and elsewhere caused by the Echinococcosis organism.