Giant air-inflated hydatid cyst of the lung mimicking massive pneumothorax

A 68-year-old Caucasian man was admitted to our emergency department with a 6-month history of progressive dyspnoea, tachycardia, chronic cough and purulent sputum production. The patient's medical history was notable for hepatic echinococcosis diagnosed in 2002. Physical examination revealed no chest wall movement, a hyper-resonant sound on percussion, absent tactile fremitus and no audible breath sound in the right hemithorax. A slight tracheal deviation towards the left could also be felt on palpation in the middle of the anterior neck behind the jugular notch of the manubrium. The heart rate was 120 bpm, blood pressure 100/65 mm Hg and SpO2 92% on room air.