Abstract
Solitary pulmonary nodule (SPN) in a heavy smoker patient is commonly considered a lung cancer. However, in endemic regions, differential diagnosis should include pulmonary hydatid cyst. We present a 65-year-old heavy smoker male with a 5 cm SPN. He had negative serology, and inconclusive PET-CT. So, it mimicked malignancy. Video-assisted thoracoscopic surgery (VATS) confirmed hydatid cyst, with successful management. This case shows the importance of considering parasitic disease in the differential diagnosis of SPN, even with negative serology and typical risk factors for lung cancer.