Introduction: Hydatid disease remains a health problem for Mediterranean and Far Eastern countries such as Iran. Living in rural or suburban areas is an important risk factor for the disease. These cysts are usually located in the liver, lung, and brain and mediastinal hydatid cysts are rarely found. The objective of this investigation was to present a very rare and nearly unique case of mediastinal hydatid cyst with invasion to right brachiocephalic vein. The patient underwent an operation successfully. Case Report: A 37-year-old female who was complaining of exertional dyspnea underwent an operation with the diagnosis of mediastinal hydatid cyst. Surgical approach was midsternotomy and because of the above-mentioned invasion, brachiocephalic vein was injured during dissection. However, the vein was repaired with a pericardial patch during the second operation and resulted SVC(superior vena cava) syndrome was resolved too. No recurrence was seen in a period of 6 month follow-up. Conclusion: Primary hydatid cysts of the mediastinum are distinct clinical entities that should be considered in a patient with a mediastinal mass who lives in endemic regions and because of surrounding vital structures, the cyst should be removed surgically without delay.
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