Serologic evidence of Echinococcus granulosus in slaughterhouses in Pakistan: global alarm for butchers in developing countries.

INTRODUCTION: Cystic echinococcosis, caused by Echinococcus granulosus, is a neglected zoonosis that affects humans and livestock. This sero-survey was designed for the first time in Pakistan to assess the exposure of butchers to E. granulosus as there was no previous report in the country for this occupational group. METHODOLOGY: Blood samples were collected from registered butchers (n = 364) in five different slaughterhouses in Faisalabad and Bahawalnagar Districts. Sera were tested for anti-Echinococcus granulosus IgG with a commercially available ELISA kit (specificity, 100%; sensitivity, 97%). RESULTS: Overall, seroprevalence was 9.61% (35/364). Butchers >30 years of age (10.34%), those involved in small ruminants butchery (11.70%), >10 years' experience (10.04%), formal education level up to middle standard (10.28%), contact with dogs (12.71%), improper/unhygienic disposal of dog feces (11.87%), and those unaware of the consequences of eating with unwashed hands (13.80%) were more seropositive with significant statistical differences (p < 0.05). Variables like previous cyst encounter, no knowledge of zoonoses and/or cystic echinococcosis, living in rural areas and the presence of stray/feral dogs in surroundings did not show any significant association (p > 0.05) with seroprevalence in butchers. The binary logistic regression model also showed a statistically significant relationship (p < 0.05) for all risk factors found statistically significant (p < 0.05) in the univariate analysis. CONCLUSIONS: This study shows high prevalence of cystic echinococcosis among butchers in Pakistan and underscores the need for educating native slaughterhouse personnel on cystic echinococcosis. It also serves as a global warning, especially in developing countries.

Expression profile of circular RNAs in cystic echinococcosis pericystic tissue.

OBJECTIVE: The aim of the present study was to investigate the expression profiles of circular RNAs (circRNAs) in the pericystic tissue of patients with cystic echinococcosis (CE). PATIENTS AND METHODS: CircRNA expression profiles were obtained by circRNA microarray of four matched pairs of pericystic tissues affected by CE and adjacent normal liver tissues. qRT-PCR was used to validate the differential expression of some circRNAs identified by the microarray analysis. The potential functions of the differentially expressed circRNAs in the CE pericystic tissues were predicted by bioinformatic analysis. RESULTS: Compared with the adjacent normal liver tissues, 177 circRNAs were upregulated and 166 circRNAs were downregulated in CE pericystic tissues based on a ≥2.0-fold change. The top 10 upregulated circRNAs were hsa_circRNA_001654,hsa_circRNA_103361,hsa_circRNA_001490,hsa_circRNA_104310,hsa_circRNA_100395,hsa_circRNA_102485,hsa_circRNA_001459,hsa_circRNA_104193,hsa_circRNA_400043, and hsa_circRNA_006773; The top 10 downregulated circRNAs were hsa_circRNA_400633,hsa_circRNA_404974,hsa_circRNA_068482 ,hsa_circRNA_100974,hsa_circRNA_049637,hsa_circRNA_404798,hsa_circRNA_400064,hsa_circRNA_004045,hsa_circRNA_101379, and hsa_circRNA_016771;The circRNA-seq results for 15 selected differentially expressed circRNAs were validated by qRT-PCR. The qRT-PCR analysis showed that hsa_circRNA_006773, hsa_circRNA_049637, hsa_circRNA_104349, and hsa_circRNA_406281 were differentially expressed in CE pericystic tissues when compared with their expression in the adjacent normal liver tissues. Interestingly, 319 miRNAs and 52 mRNAs were predicted to be adsorbed by these four differentially expressed circRNAs. Gene Ontology analysis revealed that these circRNAs may be involved in the response to organic cyclic compounds and endogenous stimuli and in cellular organismal processes. CONCLUSION: Differential expression of circRNAs may be associated with the development and progression of CE, and these circRNAs might be useful as biomarkers for prognosis prediction and as treatment targets.

Distribution of alveolar echinococcosis according to environmental and geographical factors in Germany, 1992-2018.

Alveolar echinococcosis (AE) is a rare zoonotic disease caused by the larval stage of Echinococcus multilocularis. Despite its low world-wide prevalence, this disease shows differences in the regional distribution of cases. In the present cohort study, we analyse the distribution of AE according to environmental and geographical factors in Germany. We identified the place of residence of 591 cases of AE from the national database for AE, and georeferenced these localities in the Universal Transverse Mercator coordinate system. Data on elevation, air temperature, precipitation height and land cover were mapped out and correlated with the distribution of cases of disease during the period 1992-2018. Moran's I statistic was used for spatial autocorrelation. Differences in frequency distribution between elevation, air temperature, precipitation height and landscape feature classes were analysed with the Kruskal-Wallis test. With the multiple linear regression analysis, we determined the influences and interactions of geographical and climatic factors on the number of AE cases. The results showed a heterogeneous distribution of AE cases with a higher concentration in southern Germany than in the rest of Germany (I = 0.225517, Z = 35.8182 and p < 0.001). There was a statistically significant difference in frequency distribution between precipitation height, air temperature, elevation and landscape feature classes and AE cases in Germany (p < 0.0001). In regions with higher elevations (505-672 m), moderate average air temperatures (6.0-7.9°C) and higher precipitation rates (701-1000 mm) most AE cases were recorded. It seems, that regions with higher precipitation rates, higher elevations and moderate average air temperatures have a higher infection burden and infection conditions. It is therefore extremely important to generate greater awareness of the disease in these regions, with the aim of recognising potential cases of AE as early as possible and introducing the appropriate therapeutic measures.

[Distribution and risk factors of hydatidosis in an administrative region of Chile between 2010 and 2016]. / Distribución y factores de riesgo de hidatidosis en la Región del Libertador Bernardo O'Higgins entre 2010 y 2016.

BACKGROUND: In Chile, hydatidosis is endemic throughout the country and hyperendemic in some regions. It continues to be a public health problem that has been neglected and little addressed at the national level. In the Region of Libertador Bernardo O'Higgins, reported cases and hospital discharges still show high values, this area being representative of medium risk. AIM: To estimate the risk of human hydatidosis in this region, studying the relationship of notifications and hospital discharge rates with social and environmental factors such as population, poverty index, schooling, literacy, average temperature, average rainfall and sheep population size. METHODS: Poisson regressions were used to study the factors associated with reported cases and hospital discharge rates and the BYM model for relative risk. RESULTS: We found that the factors most related to absolute risk were the schooling index as a protective factor and the average temperatures as an enhancing factor. The sheep population size was also a relevant factor, especially when analyzing the distribution of relative risk. The areas of greatest risk in the region were La Estrella, Marchigue, Litueche, Santa Cruz and Lolol according to discharge rates, adding Pumanque and Peralillo according to notifications. These reveal a distribution of the zones of risk of hydatidosis towards the coastal mountain range in this region. DISCUSSION/CONCLUSION: The more relevant factors associated to hydatidosis were schooling index, temperature an sheep population.

[Estimates of the spatial distribution of the relative risk of mortality of the main zoonoses in Chile: Chagas disease, hydatidosis, Hantavirus cardiopulmonary syndrome and leptospirosis]. / Estimaciones de la distribución espacial del riesgo relativo de mortalidad por las principales zoonosis en Chile: enfermedad de Chagas, hidatidosis, síndrome cardiopulmonar por hantavirus y leptospirosis.

BACKGROUND: Zoonoses are infections caused by all types of etiological transmissible agents from vertebrate animals to humans. During the last decades, the risk to health caused by different zoonoses has been a consequence of the natural distribution of the different etiological agents and by the emergence and reemergence of these diseases. AIM: To study the distribution of the risk of mortality of the four main zoonoses in continental Chile, based on national mortality data, with the objective of visualizing geographically where to focus the control efforts of these diseases. METHODS: Relative risk was estimated by means of Bayesian Statistics. RESULTS: The distribution in Chile of the main zoonoses was obtained. DISCUSSION/CONCLUSION: The risk maps obtained show a parasitic disease transmitted by high-risk vectors in the north, Chagas disease; a parasitic disease of biological communities in which man is an accidental host, associated with livestock areas, more prevalent in the south, hydatidosis; a bacterial disease transmitted by vertebrates, especially by rodents, where water is an important vehicle, dominant in the center, leptospirosis; and a viral disease transmitted by rodents, very dominant in the south, the hantavirus infection.

Epidemiology of echinococcosis in Iran: a systematic review and meta-analysis.

BACKGROUND: Echinococcosis is a zoonotic disease caused by the larval stages of taeniid cestodes of the genus Echinococcus. The two major types of infection in humans are cystic echinococcosis (CE) or hydatidosis and alveolar echinococcosis (AE). It is endemic in some parts of the world, such as the Middle East, with Iran being a part of it. This systematic review and meta-analysis were conducted to determine the prevalence of CE and AE echinococcosis and their epidemiological and clinical aspects in Iran. METHODS: Electronic databases, including MEDLINE (via PubMed), SCOPUS, Web of Science, SID and Mag Iran (two Persian scientific search engines) were searched from 1 January 1990 to 8 August 2017. The prevalence of CE and AE echinococcosis was estimated using the random effects meta-analysis. Heterogeneity was evaluated by subgroup analysis. Data were analyzed by STATA version 12. RESULTS: Of the 2051 records identified in the mentioned electronic databases, Seventy-eight articles met our eligibility criteria, with a total of 214124individuals. The meta-analysis was performed on only 37 out of 78 included studies. The pooled prevalence of CE and AE in Iran was 5% [95% confidence interval )CI(: 3-6%] and 2% [95% CI: 0-5%], respectively. Subgroup meta-analysis revealed that the prevalence of CE was significantly higher in North [9%, 95% CI: 4-18%] and West of Iran [6%, 95% CI: 3-11%], patients younger than 40 years of age [7%, 95% CI: 4-12%], villagers and nomads [6%, 95% CI: 2-12%], and studies that used the combination of serological, clinical, and imaging diagnostic methods [7%, 95% CI: 5-9%]. There were no significant differences between the prevalence of CE among low and high-quality studies. Housewives were the most affected group by hydatidosis (n=24/77, 31%), followed by illiterate people (n=11/77, 14%) and farmers (n= 9/77, 12%). Liver [55%, 95% CI: 46-65%] and lung [28%, 95% CI, 22-35%] were the most common sites of cyst formation. CONCLUSIONS: Given to the importance of echinococcosis on human health and domestic animals industry, it is necessary to implement monitoring and control measures in this regard.

Distribución y factores de riesgo de hidatidosis en la Región del Libertador Bernardo O'Higgins entre 2010 y 2016 / Distribution and risk factors of hydatidosis in an administrative region of Chile between 2010 and 2016

Resumen Introducción: En Chile, la hidatidosis, endémica a lo largo de todo el país e hiperendémica en algunas regiones, sigue siendo un problema de salud pública desatendido y poco abordado por el Estado. En la Región del Libertador Bernardo O'Higgins, los casos reportados y los egresos hospitalarios aún muestran valores elevados, siendo esta zona representativa de riesgo medio. Objetivo: Estimar el riesgo de hidatidosis humana en esta región, estudiando la relación de las notificaciones y egresos con factores sociales y ambientales, tales como población, índice de pobreza, índice de escolaridad, alfabetización, temperatura media, precipitación media y masa ganadera ovina. Metodología: Se utilizaron regresiones de Poisson para estudiar los factores asociados a enfermedades de notificación obligatoria y egresos y el modelo Besag-York-Mollie para el riesgo relativo. Resultados: Los factores más relacionados con el riesgo absoluto fueron el índice de escolaridad como factor protector y las temperaturas medias como factor potenciador. La población ovina fue también un factor relevante especialmente al analizar la distribución del riesgo relativo. Las zonas de mayor riesgo en la región fueron La Estrella, Marchigüe, Litueche, Santa Cruz y Lolol según egresos, agregando a Pumanque y Peralillo según notificaciones. Éstas revelan una distribución de las zonas de riesgo de hidatidosis hacia la cordillera de la costa en esta región. Conclusiones: En esta región los principales predictores de riesgo de hidatidosis son el índice de escolaridad, la temperatura y la población ovina.

Background: In Chile, hydatidosis is endemic throughout the country and hyperendemic in some regions. It continues to be a public health problem that has been neglected and little addressed at the national level. In the Region of Libertador Bernardo O'Higgins, reported cases and hospital discharges still show high values, this area being representative of medium risk. Aim: To estimate the risk of human hydatidosis in this region, studying the relationship of notifications and hospital discharge rates with social and environmental factors such as population, poverty index, schooling, literacy, average temperature, average rainfall and sheep population size. Methods: Poisson regressions were used to study the factors associated with reported cases and hospital discharge rates and the BYM model for relative risk. Results: We found that the factors most related to absolute risk were the schooling index as a protective factor and the average temperatures as an enhancing factor. The sheep population size was also a relevant factor, especially when analyzing the distribution of relative risk. The areas of greatest risk in the region were La Estrella, Marchigue, Litueche, Santa Cruz and Lolol according to discharge rates, adding Pumanque and Peralillo according to notifications. These reveal a distribution of the zones of risk of hydatidosis towards the coastal mountain range in this region. Discussion/Conclusion. The more relevant factors associated to hydatidosis were schooling index, temperature an sheep population.

Estimaciones de la distribución espacial del riesgo relativo de mortalidad por las principales zoonosis en Chile: enfermedad de Chagas, hidatidosis, síndrome cardiopulmonar por hantavirus y leptospirosis / Estimates of the spatial distribution of the relative risk of mortality of the main zoonoses in Chile: Chagas disease, hydatidosis, Hantavirus cardiopulmonary syndrome and leptospirosis

Resumen Introducción: Las zoonosis son enfermedades o infecciones causadas por todo tipo de agentes etiológicos transmisibles desde animales vertebrados a humanos. Durante las últimas décadas, el riesgo para la salud ocasionado por diferentes zoonosis, ha sido generado por la distribución natural de los distintos agentes etiológicos y por la emergencia y reemergencia de estas enfermedades. Objetivo: Estudiar la distribución del riesgo de mortalidad de las cuatro principales zoonosis en Chile continental, basados en datos nacionales de mortalidad, con el objetivo de visualizar geográficamente donde focalizar los esfuerzos de control de estas enfermedades. Metodología: Se estima el riesgo relativo de las principales zoonosis en Chile, mediante estadística Bayesiana. Resultados: Se obtuvo la distribución de las cuatro principales zoonosis de Chile. Discusión/Conclusión: Se obtuvo la distribución de las cuatro principales zoonosis de Chile. Los mapas de riesgo obtenidos muestran una enfermedad parasitaria transmitida por vectores de alto riesgo en el norte, la enfermedad de Chagas; una enfermedad parasitaria de comunidades biológicas en que el hombre es un hospedero accidental, asociada a zonas ganaderas, prevalente en el sur, la hidatidosis; una enfermedad bacteriana transmitida por vertebrados, especialmente por roedores, donde el agua es un vehículo importante, dominante en el centro, la leptospirosis; y una enfermedad viral transmitida por roedores, muy dominante en el sur, la infección por hantavirus.

Background: Zoonoses are infections caused by all types of etiological transmissible agents from vertebrate animals to humans. During the last decades, the risk to health caused by different zoonoses has been a consequence of the natural distribution of the different etiological agents and by the emergence and reemergence of these diseases. Aim: To study the distribution of the risk of mortality of the four main zoonoses in continental Chile, based on national mortality data, with the objective of visualizing geographically where to focus the control efforts of these diseases. Methods: Relative risk was estimated by means of Bayesian Statistics. Results: The distribution in Chile of the main zoonoses was obtained. Discussion/Conclusion: The risk maps obtained show a parasitic disease transmitted by high-risk vectors in the north, Chagas disease; a parasitic disease of biological communities in which man is an accidental host, associated with livestock areas, more prevalent in the south, hydatidosis; a bacterial disease transmitted by vertebrates, especially by rodents, where water is an important vehicle, dominant in the center, leptospirosis; and a viral disease transmitted by rodents, very dominant in the south, the hantavirus infection.

Intestinal parasites including Cryptosporidium, Cyclospora, Giardia, and Microsporidia, Entamoeba histolytica, Strongyloides, Schistosomiasis, and Echinococcus: Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice.

These updated guidelines from the Infectious Diseases Community of Practice of the American Society of Transplantation review the diagnosis, prevention, and management of intestinal parasites in the pre- and post-transplant period. Intestinal parasites are prevalent in the developing regions of the world. With increasing travel to and from endemic regions, changing immigration patterns, and the expansion of transplant medicine in developing countries, they are increasingly recognized as a source of morbidity and mortality in solid-organ transplant recipients. Parasitic infections may be acquired from the donor allograft, from reactivation, or from de novo acquisition post-transplantation. Gastrointestinal multiplex assays have been developed; some of the panels include testing for Cryptosporidium, Cyclospora, Entamoeba histolytica, and Giardia, and the performance is comparable to conventional methods. A polymerase chain reaction test, not yet widely available, has also been developed to detect Strongyloides in stool samples. New recommendations have been developed to minimize the risk of Strongyloides donor-derived events. Deceased donors with epidemiological risk factors should be screened for Strongyloides and recipients treated if positive as soon as the results are available. New therapeutic agents and studies addressing the optimal treatment regimen for solid-organ transplant recipients are unmet needs.

El quiste hidatídico como causa del síndrome de Pancoast: extraña asociación / Hydatid cyst causing Pancoast syndrome: A rare settlement

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Hydatid cysts in Classical and late Antiquity / Quistes hidatídicos en la Antigüedad clásica y tardía

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Suppression of mouse miRNA-222-3p in response to Echinococcus multilocularis infection.

During Echinococcus multilocularis infection, serum miR-222-3p is dramatically downregulated, but its role is yet to be established. Here the expression of miR-222-3p in the spleen of infected mice was shown to be significantly decreased in response to parasite infection (p < 0.05). Using RAW264.7 macrophages, it was further demonstrated that E. multilocularis crude antigens significantly inhibited miR-222-3p expression (p < 0.01). In macrophages transfected with a miR-222-3p inhibitor, NO secretion was moderately decreased compared with the control (p < 0.05). Although all the pro- and anti-inflammatory cytokine genes tested kept constant in expression, four key genes involved in the LPS/TLR4 signaling pathway were significantly down- or up-regulated in transfected cells (p < 0.05), including CD14, TLR4, TICAM2 and AP-1. These results suggest that downregulated miR-222-3p is capable of modulating macrophage immune functions, possibly contributing to the pathogenesis during E. multilocularis infection.

Association Between Secondary Peritoneal Hydatidosis and Peritoneal Carcinomatosis from Ovarian Cancer - A Case Report.

Peritoneal carcinomatosis from ovarian cancer is unfortunately a very common finding, especially in patients diagnosed in very late stages of the disease. Nonetheless, it is not the only pathological condition inducing a diffuse involvement of the peritoneum; other entities can have an infectious or miscellaneous origin. However, the association of peritoneal carcinomatosis and parasitic infection has never been reported so far. We present the case of a 50-year-old patient who had been submitted to surgery for a hepatic hydatid cyst. Four years later, the patient was diagnosed with disseminated peritoneal lesions, which proved to have both parasite and neoplastic origin. The patient was re-submitted to surgery, and debulking resection of all pathological lesions was achieved. Although it is very rare, the association of peritoneal carcinomatosis and peritoneal hydatidosis should be taken into consideration whenever the patient reports a suggestive medical history for those two pathological findings.

Recurrence of cystic echinococcosis in an endemic area: a retrospective study.

BACKGROUND: Cystic echinococcosis (CE) is a chronic, complex and neglected zoonotic disease. CE occurs worldwide. In humans, it may result in a wide spectrum of clinical manifestations, ranging from asymptomatic infection to fatal disease. Clinical management procedures have evolved over decades without adequate evaluation. Despite advances in surgical techniques and the use of chemotherapy, recurrence remains one of the major problems in the management of hydatid disease. The aim of this study was to determine the frequency of CE recurrence and the risk factors involved in recurrence. METHODS: A descriptive longitudinal-retrospective study was designed. We reviewed all patients diagnosed with CE according to ICD-9 (code 122-0 to 122-9) criteria admitted at Complejo Asistencial Universitario de Salamanca, Spain, between January 1998 and December 2015. RESULTS: Among the 217 patients studied, 25 (11.5%) had a hydatid recurrence after curative intention treatment. Median duration of recurrence's diagnosis was 12.35 years (SD: ±9.31). The likelihood of recurrence was higher [OR = 2.7; 95% CI, 1.1-7.1; p < 0.05] when the cyst was located in organs other than liver and lung, 22.6% (7/31) vs 14.2% (31/217) in the cohort. We detected a chance of recurrence [OR = 2.3; 95% CI, 1.4-6.5; p > 0.05] that was two times higher in those patients treated with a combination of antihelminthic treatments and surgical intervention (20/141, 14.2%) than in patients treated with surgical intervention alone (5/76, 6.6%). CONCLUSIONS: Despite advances in diagnosis and therapeutic techniques in hydatid disease, recurrence remains one of the major problems in the management of hydatid disease. The current management and treatment of recurrences is still largely based on expert opinion and moderate-to-poor quality of evidence. Consequently, large prospective and multicenter studies will be needed to provide definitive recommendations for its clinical management.

Surgical Procedure Choice for Removing Hepatic Cysts of Echinococcus granulosus in Children.

Aim This study aims to evaluate the effectiveness of radical and conservative surgical procedures for removal of hydatid cysts in the liver of children. Methods A total of 112 pediatric patients had surgical treatment of hepatic cystic echinococcosis (CE) between January 2002 and December 2012 at the First Affiliated Hospital of Xinjiang Medical University were retrospectively evaluated. The patients were divided into two groups receiving either radical (n = 26) or conservative surgery (CS) (n = 86). Patient age, gender, symptoms, preoperative radiologic investigations, type of cyst, involvement of other organs, surgical procedure performed, postoperative complications, and mean hospital stay after surgery were recorded. Results The mean surgical procedure time for radical surgery (RS) was significantly longer than CS (126.4 ± 37 vs. 90.4 ± 22.9 minutes, p < 0.001], and the days for hospitalization showed no difference (11.0 ± 2.1 vs. 11.5 ± 3.1 days, p > 0.05]. Seven patients in the CS group had 20-300 mL of bile drainage 2-4 days post-operation and two patients developed a postoperative cavitary abscess; five patients in the RS group and one patient in the CS group developed a hydrothorax on the fifth day postoperatively. Follow-up of all patients showed that the majority had recovered well except for 3 cases who developed recurrences due to cysts ruptured accidently before surgery. There were no recurrences or biliary complications in the RS group. Conclusion CS is an effective method for liver CE cyst removal and RS is suitable for hepatic cysts in less risk position in pediatric patients.

Rapid urbanization of red foxes in Estonia: distribution, behaviour, attacks on domestic animals, and health-risks related to zoonotic diseases.

Urban areas are becoming increasingly important for wildlife as diminishing natural habitats no longer represent a suitable environment for many species. Red foxes (Vulpes vulpes) are nowadays common in many cities worldwide, and in recent years they have colonized urban areas in Estonia. We used a public web-based questionnaire approach to evaluate the distribution and behaviour of Estonian urban foxes, to detect related problems and to assess health risks to humans and domestic animals. In total, 1205 responses were collected throughout the country. Foxes have colonized the majority of Estonian towns (33 out of 47) in a relatively short period of time, and have already established breeding dens in several towns. Despite their recent arrival, the behaviour of Estonian urban foxes is similar to that reported in longer-established urban fox populations: they are mostly active during night-time, often visit city centres and some also have dens in such locations. Certain characteristics of urban foxes serve as a basis for conflict with humans: foxes have entered houses and attacked domestic animals, killing cats and poultry. About 8% of reported foxes exhibited symptoms of sarcoptic mange, a disease that also infects domestic animals, especially dogs. The proportion of mange-infected foxes was higher in large urban areas. In addition to mange, a substantial fraction of red foxes in Estonia are known to be infected with the life-threatening tapeworm Echinococcus multilocularis, the causative agent of alveolar echinococcosis. Therefore, urban foxes may represent a source of serious infectious disease for pets and humans.

[Benign cysts of the mediastinum: series of 28 cases]. / Les kystes bénins du médiastin : à propos de 28 cas.

INTRODUCTION: Benign cystic mediastinal mass form a group of heterogeneous and uncommon lesions. Surgical resection is the gold standard in these conditions. We reported our institutional experience in management of these benign tumours. In this review, cardiac and ganglionary benign mass were excluded. METHODS: We retrospectively reviewed the records of 28 patients with benign cysts of the mediastinum, who are operated in our department between January 2003 and December 2009 (7years period). RESULTS: There were 13 females (46.4%) and 15 males (53.5%), with a mean age of 36.8years (range: 13-63years). Most lesions (n=22) were equally in the anterior and middle mediastinum, only six were in the posterior mediastinum. Seventeen patients (60.7%) were symptomatic, with chest pain and cough as the most common symptoms. The diagnosis of mediastinal cyst was fortuitous in 11 patients with the waning of an assessment made for another reason. Surgery was indicated in all patients in order to both diagnostic and therapeutic. Posterolateral thoracotomy incision is the most common. Complete resection of the cyst was possible only in 18 cases (64.3%), whereas in ten (35. 7%) other cases part of the cyst was left in place due to tight adhesions to vital structures. After histological study, there were: nine bronchogenic cysts (32.1%), seven hydatid cysts (25%), four cystic lymphangiomas (14.3%), three mature cystic teratomas (10.7%) and three pleuropericardial cysts, one thymic cyst and one parathyroid cyst. The postoperative course was uneventful and no recurrence has been observed until now. CONCLUSION: The benign cysts of the mediastinum is a rare entity, the hydatid etiology remains common in our context. Surgical treatment remains the treatment of choice for mediastinal cysts, when the patient is operable, to save the risk of complications or degeneration.