Alveolar echinococcosis located in the liver: Report of a case

Abstract

Echinococcosis is a parasitic infection caused by larval and cyst stages of Echinococcus granulosus living in dogs in humans. The definitive host of the parasite is dog, intermediate hosts are sheep, cattle and humans. The causative pathogen is mostly Echinococcus granulosus. Echinococcus multilocularis (alveolaris) and other agents are less common. Only 3% of hepatic hydatid cysts are alveolar hydatid cysts. In this study, we aimed to present a case of Alveolar echinococcosis located in the right lobe of the liver due to Ecinococcus alveolaris, together with the operation images. We evaluated the preoperative, peroperative and postoperative course of a patient who was examined with abdominal pain in our clinic and in radiological and serological examinations, we found an alveolar hydatid cyst located in the liver and underwent surgery. Our patient was a 31-year-old female. She applied for abdominal pain. Ultrasonography revealed a cystic mass of approximately 17 cm in diameter in the right lobe of the liver. In laboratory examinations, the hydatid hemagglutination test was positive at a titer of 1/2560. Hematological and biochemical parameters were normal. MRI showed a 171*125 mm sized, lobulated, locally calcified cystic mass in the right lobe of the liver. After evaluating the relationship of the lesion defined in CT angiography imaging with vascular structures, the decision to operate was made with the diagnosis of Alveolar echinococcosis.. Nonanatomical segmental right hepatectomy and total cyst excision operation was performed in our patient who was thought to have Alveolar echinococcosis based on clinical, serological and radiological findings. The patient, who had an uneventful postoperative period, was discharged on the 7th postoperative day with full recovery. In cases of echinococcosis, the treatment is determined according to the type of the agent, the stage and localization of the lesion. Medical treatment, PAIR and surgery are the treatment options that can be applied. Total excision of the mass is recommended in cases of Alveolar echinococcosis.