Abstract

Background: This study retrospectively analyzed the clinical data, laboratory results, imaging findings, and histopathological features of 28 patients who underwent ultrasound-guided core-needle biopsy from a hepatic lesion and were diagnosed with alveolar echinococcosis. Results: Among 28 patients included in the study, 16 were females and 12 were males. The mean age of the studied population was 53 ± 16 years, and the age range was 18–79 years. The most common presenting symptom was abdominal pain, which was observed in 14 patients. A total of 36 lesions were detected in the patients’ livers, out of which 7 had a cystic appearance. Hepatic vascular involvement, bile duct involvement, and other organ involvement were depicted in 14, 5, and 7 patients, respectively. The average number of cores taken from the lesions was 2.7, ranging between 2 and 5. In histopathological evaluation, PAS+ parasitic membrane structures were visualized on a necrotic background in all cases. Regarding seven patients, who were operated, the pathological findings of preoperative percutaneous biopsies were in perfect agreement with the pathological examinations after surgical resections. None of the patients developed major complications after biopsy. Conclusion: Ultrasound-guided core-needle biopsy is a minimally invasive, reliable, and effective diagnostic tool for the definitive diagnosis of hepatic alveolar echinococcosis.

Highlights

  • Alveolar echinococcosis (AE) is a rare zoonotic infection that affects humans as coincidental intermediate hosts

  • The diagnosis of AE was coincidental in 18 patients, while in the rest of the cases, AE was considered in the list of differential diagnoses

  • While lifelong treatment with albendazole is administered in unresectable patients and patients with R2 resection, patients with R0 and R1 resection are postoperatively treated for 2 years

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Summary

Introduction

Alveolar echinococcosis (AE) is a rare zoonotic infection that affects humans as coincidental intermediate hosts. The infection is contracted by humans via ingesting adult Echinococcus multilocularis eggs. AE is a progressive disease that can result in death unless treated. Its primary site of involvement is the liver, from where it may spread to nearby organs by direct invasion, or distant organs by metastasis. The metacestode stage of the parasite leads to the formation of slowly growing, infiltrative, tumor-like mass lesions in affected organs. As a result of these characteristics, AE lesions may be confused with malignant lesions [13]

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