• Xiaoguang Ma, Wei Su, Xiao Wang, and Rui Zhao.
• Department of Hepatobiliary Surgery, Qinghai Red Cross Hospital, Xining, Qinghai, China.
• Medicine (Baltimore). 2023 Oct 27; 102 (43): e35806e35806.

RationaleHepatic Echinococcosis, is a zoonotic Parasitic disease with a worldwide distribution. Clinical cases of alveolar echinococcosis combined with cystic echinococcosis infection are extremely rare.Patient ConcernsA 58-year-old patient had found liver occupying lesions for more than 2 years. A left hepatic alveolar hydatid was found, occupying the entire left half of the liver, with a size of approximately 6.7 cm × 10.9 cm × 8.1 cm. The size of the right liver is about 9 × 8 cm cystic hydatid, mainly located in the S5 segment of the liver. Abdominal examination: the upper abdomen is swollen, and a hard mass can be touched under the right rib margin, with tenderness and no rebound pain. The bowel sounds are normal.DiagnosesAbdominal MR shows an increase in liver volume and irregular morphology, with patchy abnormal signal shadows visible in the left lobe of the liver, with a range of approximately 6.7 cm × 10.9 cm × 8.1 cm, low signal on T1WI, low signal on T2WI and FS-T2WI, slightly high signal on diffusion weighted imaging, high signal on apparent diffusion coefficient, no significant enhancement of the lesion after enhancement. In addition, there is a clump like abnormal signal shadow visible in the right lobe of the liver, with a size of approximately 7.9 cm × 7.3 cm × 7.9 cm, low signal on T1WI, mixed high signal on T2WI, high signal on diffusion weighted imaging, mixed signal on apparent diffusion coefficient. Consider: Left lobe alveolar echinococcosis, and right lobe cystic echinococcosis (CE III type).InterventionsA radical resection was performed, including expanded left hemi-hepatectomy, cholecystectomy, right hepatic lesion resection, partial right hepatic duct resection with right hepatic duct jejunostomy.OutcomesThe wound healed well after resection. There was no recurrence of TC after 4 years follow-up.LessonsThe co-infection of alveolar echinococcosis and cystic echinococcosis in a patient is an exceedingly rare occurrence. Radical resection is the only curative treatment.Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.

8 keywords...

hide…