An extremely rare localization of Echinococcus alveolaris; pancreas

Abstract

Background: Echinococcus alveolaris causes a zoonotic infestation and behaves like a malignant tumor. Here, we present a case of pancreatic echinococcus alveolaris. Methods: A 29-year old young woman was admitted to the clinic with abdominal pain, distention and nausea. Bilirubin level was slightly high. Abdominal sonography and contrast enhanced abdominal computed tomography revealed a pancreatic head mass 6 cm in diameter, compressing portal vein, arteria hepatica propria and vena cava inferior. Fine needle aspiration biopsy using endosonography was performed but the biopsy was not diagnostic. Pancreaticoduodenectomy was planned. Frozen section biopsy was performed during the surgery. The results were consistent with E. alveolaris infestation. Pancreaticoduodenectomy was performed. Postoperative period was uneventful, and the patient was discharged on postoperative 8th day. Results: Echinococcus alveolaris can be seen in liver, lung, brain. There is only one cese report of isolated pancreatic infestation due to E. alveolaris. The infestations by E. alveolaris resemble neoplastic diseases but show comparatively slower progression. The disease mimics a slow-growing tumour. For the diagnosis, serological procedures, ultrasonography, CT and MRI scans are helpful. Conclusion: Alveolar echinococcus infestation is not so common compared to E. granulosus. The most common localization is the liver. It can be concomittantly seen in any other organ with liver. Isolated pancreatic infestation is extremely rare.