Alveolar echinococcosis – a neglected diagnosis of liver lesions

Czech version

Authors: A. Kapľavka
Authors‘ workplace: Gastroenterologická poradna, Nemocnice AGEL Nový Jičín a. s.
Published in: Gastroent Hepatol 2025; 79(2): 127-129
Category: Hepatology
doi: https://doi.org/10.48095/ccgh2025127

Overview

Alveolar echinococcosis (AE) is a rare but serious parasitic liver disease that often mimics malignant lesions. We present the case of a 76-year-old patient in whom AE was incidentally diagnosed during examination for renal insufficiency. Abdominal ultrasound revealed multiple hyperechogenic liver lesions. Subsequent MRI showed multiple irregularly bordered lesions without typical vascularization, the largest measuring 71 × 38 mm. Laboratory tests revealed elevated liver enzymes, CRP, and renal insufficiency. A core-cut liver biopsy confirmed the presence of pseudocystic structures. Samples were sent to the National Reference Laboratory for Tissue Helminthiases, which confirmed the diagnosis of AE. Serological testing was performed after the biopsy confirming the presence of antibodies against Echinococcus multilocularis. The patient was referred to an infectious disease clinic, where treatment with albendazole at a dose of 800 mg daily was initiated. After rehydration and adjustment of therapy, renal function stabilized, and follow-up imaging showed stable findings. This case highlights the need to include AE in the differential diagnosis of hepatic lesions, particularly in patients without an oncological history.

Keywords:

echinococcosis – liver – diagnosis – histology – biopsy – imaging methods – albendazole

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