Two Cases of Disseminated Alveolar Echinococcosis: The Diagnosis, Management, and Differential Considerations for Liver Lesions

Overview

Journal Intern Med

Specialty General Medicine

Date 2023 Oct 1

PMID 37779063

Authors

Kazuki Hirano

Yuta Maruki

Daiki Yamashige

Osamu Kobayashi

Mika Shiotsuka

Chigusa Morizane

Tsunao Imamura

Nobuyoshi Hiraoka

Takuji Okusaka

Affiliations

Soon will be listed here.

Abstract

Alveolar echinococcosis (AE), caused by Echinococcus multilocularis, is an aggressive and potentially critical infestation that primarily affects the liver and can metastasize to any part of the body. We herein report two cases of echinococcosis, which could be differentiated from malignancy on imaging studies, with infections of the liver and mediastinal lymph nodes, and also associated with systemic disseminated lesions. AE is a very invasive infectious disease, and in order to detect such lesions at an early stage when they are still resectable, it is necessary to understand the characteristic imaging findings and determine the patient's current medical history.

References

Harman M, Arslan H, Kotan C, Etlik O, Kayan M, Deveci A . MRI findings of hepatic alveolar echinococcosis. Clin Imaging. 2003; 27(6):411-6. DOI: 10.1016/s0899-7071(03)00006-8. View

McManus D, Zhang W, Li J, Bartley P . Echinococcosis. Lancet. 2003; 362(9392):1295-304. DOI: 10.1016/S0140-6736(03)14573-4. View

Rozanes I, Acunas B, Celik L, Minareci O, Gokmen E . CT in lobar atrophy of the liver caused by alveolar echinococcosis. J Comput Assist Tomogr. 1992; 16(2):216-8. DOI: 10.1097/00004728-199203000-00008. View

Balci N, Tunaci A, Semelka R, Tunaci M, Ozden I, Rozanes I . Hepatic alveolar echinococcosis: MRI findings. Magn Reson Imaging. 2000; 18(5):537-41. DOI: 10.1016/s0730-725x(00)00145-4. View

Lanier A, Trujillo D, Schantz P, Wilson J, Gottstein B, McMahon B . Comparison of serologic tests for the diagnosis and follow-up of alveolar hydatid disease. Am J Trop Med Hyg. 1987; 37(3):609-15. DOI: 10.4269/ajtmh.1987.37.609. View

Ito A, Schantz P, Wilson J . Em18, a new serodiagnostic marker for differentiation of active and inactive cases of alveolar hydatid disease. Am J Trop Med Hyg. 1995; 52(1):41-4. DOI: 10.4269/ajtmh.1995.52.41. View

Akhan O, Ozmen M . Percutaneous treatment of liver hydatid cysts. Eur J Radiol. 1999; 32(1):76-85. DOI: 10.1016/s0720-048x(99)00116-3. View

Emre A, Ozden I, Bilge O, Arici C, Alper A, Okten A . Alveolar echinococcosis in Turkey. Experience from an endemic region. Dig Surg. 2003; 20(4):301-5. DOI: 10.1159/000071695. View

Akin O, Isiklar I . Hepatic alveolar echinococcosis. A case report. Acta Radiol. 1999; 40(3):326-8. DOI: 10.3109/02841859909175562. View

10.

Reuter S, Buck A, Manfras B, Kratzer W, Seitz H, Darge K . Structured treatment interruption in patients with alveolar echinococcosis. Hepatology. 2004; 39(2):509-17. DOI: 10.1002/hep.20078. View

11.

Ammann R, Eckert J . Cestodes. Echinococcus. Gastroenterol Clin North Am. 1996; 25(3):655-89. DOI: 10.1016/s0889-8553(05)70268-5. View

12.

Ishizu H, Uchino J, Sato N, Aoki S, Suzuki K, Kuribayashi H . Effect of albendazole on recurrent and residual alveolar echinococcosis of the liver after surgery. Hepatology. 1997; 25(3):528-31. DOI: 10.1002/hep.510250305. View

13.

McManus D, Gray D, Zhang W, Yang Y . Diagnosis, treatment, and management of echinococcosis. BMJ. 2012; 344:e3866. DOI: 10.1136/bmj.e3866. View

14.

Azizi A, Blagosklonov O, Lounis A, Berthet L, Vuitton D, Bresson-Hadni S . Alveolar echinococcosis: correlation between hepatic MRI findings and FDG-PET/CT metabolic activity. Abdom Imaging. 2014; 40(1):56-63. DOI: 10.1007/s00261-014-0183-0. View

15.

Bulakci M, Kartal M, Yilmaz S, Yilmaz E, Yilmaz R, Sahin D . Multimodality imaging in diagnosis and management of alveolar echinococcosis: an update. Diagn Interv Radiol. 2016; 22(3):247-56. PMC: 4859741. DOI: 10.5152/dir.2015.15456. View

16.

Schantz P, Wilson J, Wahlquist S, Boss L, RAUSCH R . Serologic tests for diagnosis and post-treatment evaluation of patients with alveolar hydatid disease (Echinococcus multilocularis). Am J Trop Med Hyg. 1983; 32(6):1381-6. DOI: 10.4269/ajtmh.1983.32.1381. View

17.

Altintas N . Cystic and alveolar echinococcosis in Turkey. Ann Trop Med Parasitol. 1999; 92(6):637-42. View

18.

Eckert J, Conraths F, Tackmann K . Echinococcosis: an emerging or re-emerging zoonosis?. Int J Parasitol. 2000; 30(12-13):1283-94. DOI: 10.1016/s0020-7519(00)00130-2. View

19.

Koroglu M, Akhan O, Gelen M, Koroglu B, Yildiz H, Kerman G . Complete resolution of an alveolar echinococcosis liver lesion following percutaneous treatment. Cardiovasc Intervent Radiol. 2005; 29(3):473-8. DOI: 10.1007/s00270-005-0017-0. View

20.

Turkcapar A, Ersoz S, Gungor C, Aydinuraz K, Yerdel M, Aras N . Surgical treatment of hepatic hydatidosis combined with perioperative treatment with albendazole. Eur J Surg. 1998; 163(12):923-8. View