Autopsy and Case Reports
https://autopsyandcasereports.org/article/doi/10.4322/acr.2024.474
Autopsy and Case Reports
Clinical Case Report

Hepatic alveolar echinococcosis simulating metastatic malignancy

Suvradeep Mitra; Payal Charaya; Shrinath Gururaj Deshpande; Mayur Parkhi; Thakur Deen Yadav

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Abstract

Echinococcosis is a parasitic disease caused by infection with tiny tapeworms of the genus Echinococcus. Echinococcosis is classified as either cystic echinococcosis or alveolar echinococcosis. The common form is a zoonosis from goats and sheep that tends to cause liver lesions. The larval stage of Echinococcus multilocularis causes alveolar echinococcosis/alveolar hydatid disease. It is a zoonosis with field mice and tundra voles as intermediate and wild carnivores like foxes and wolves as definitive hosts. This zoonosis is highly uncommon compared to the other form known as cystic echinococcosis but poses a great human threat if untreated. We report the case of a young man who was working in the Kashmir Valley, North India, and presented with jaundice and right upper quadrant abdominal pain. Computed tomography revealed a large solid-cystic intrahepatic lesion measuring 125x118x123 mm, suggestive of a malignant tumor with central necrosis. A liver biopsy showed necrosis with PAS-positive membranes morphologically consistent with echinococcosis. Alveolar echinococcosis can present as a solid-cystic mass in the liver and can simulate metastatic malignancy.

Keywords

Keywords: Liver, Echinococcosis, Neoplasm Metastasis, Pathology

References

1 Aikat BK, Bhusnurmath SR, Cadersa M, Chhuttani PN, Mitra SK. Echinococcus multilocoularis infection in India: first case report proved at autopsy. Trans R Soc Trop Med Hyg. 1978;72(6):619-21. http://dx.doi.org/10.1016/0035-9203(78)90015-9. PMid:734718.

2 Bansal N, Vij V, Rastogi M, Wadhawan M, Kumar A. A report on three patients with Echinococcus multilocularis: lessons learned. Indian J Gastroenterol. 2018;37(4):353-8. http://dx.doi.org/10.1007/s12664-018-0860-y. PMid:30121887.

3 Khuroo MS, Datta DV, Khoshy A, Mitra SK, Chhuttani PN. Alveolar hydatid disease of the liver with Budd-Chiari syndrome. Postgrad Med J. 1980;56(653):197-201. http://dx.doi.org/10.1136/pgmj.56.653.197. PMid:7393812.

4 Prabhakar N, Kalra N, Behera A, et al. Large heterogeneous calcified masses in liver: a diagnostic dilemma. J Clin Exp Hepatol. 2017;7(4):385-6. http://dx.doi.org/10.1016/j.jceh.2017.09.001. PMid:29234206.

5 Zhang X, Wei X, Ran L, Tang H. A rare case of cardiac alveolar echinococcosis. Eur Heart J. 2020;41(28):2698. http://dx.doi.org/10.1093/eurheartj/ehaa511. PMid:32702740.

6 Brunetti E, Kern P, Vuitton DA. Expert consensus for the diagnosis and treatment of cystic and alveolar echinococcosis in humans. Acta Trop. 2010;114(1):1-16. http://dx.doi.org/10.1016/j.actatropica.2009.11.001. PMid:19931502.
 


Submitted date:
01/11/2024

Accepted date:
01/26/2024

Publication date:
02/08/2024

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