A CASE OF CYSTIC HYDATID DISEASE OF THE LIVER DIAGNOSED BEFORE SURGERY

Abstract

Cystic hydatid disease of the liver has been unusual in Japan. However, the recently increasing immigration from endemic areas might lead to a rise in the prevalence of this disease in Japan. We report a case of cystic hydatid disease of the liver which was diagnosed preoperatively. A 28-year-old nepalese man was admitted with a chief complaint of abdominal discomfort. He had lived in Nepal 2 months before. A tumor 8×12cm in size was palpated in the upper abdomen. Mild eosinophilia and increased biliary enzymes were observed. Abdominal US and CT revealed two large multivesicular cysts with thin septa in the left lobe of the liver, and a univesicular cyst in the left medial and right anterior inferior segment of the liver. MRI showed well-defined, low-intensity rims which surrounded each cyst on a T2-weighted image. From these findings and his history, we diagnosed hepatic hydatid disease. The diagnosis was confirmed by serological testing. Extended left hepatic lobectomy was performed. Protoscoleces of Echinococcus granulosus were detected in the serouns fluid aspirated from the cyst.