Abstract
BACKGROUND: Cystic echinococcosis, or hydatid cystic disease, is a globally prevalent zoonotic infection that typically affects the liver or lungs. CASE SUMMARY: A 28-year-old man residing in the UAE presented with chronic hemoptysis, melena, and weight loss. Chest radiography revealed multiple bilateral lung nodules, and a subsequent surgical lung biopsy confirmed necrotizing granulomatous inflammation, suggestive of a chronic inflammatory process. Although initially delayed, transthoracic echocardiography detected a cystic mass (2.4 × 2.0 cm) and a solid mass (1.0 × 0.9 cm) on the right ventricular free wall, with no impact on right ventricle function. Albendazole treatment was initiated based on positive hydatid serology, followed by cardiac magnetic resonance imaging and surgical excision of the cardiac masses. DISCUSSION: Cardiac involvement in cystic echinococcosis accounts for only 0.5% to 2% of cases, with right ventricular localization reported in approximately 10% of those. This case highlights the diagnostic complexity of echinococcosis and underscores the importance of comprehensive evaluation and individualized management, particularly in young adults.