Department of Surgical Gastroenterology, Bangalore Medical College and Research Institute, Bangalore, Karnataka, India.
Department of Surgical Gastroenterology, Cytecare Cancer Hospital, Bangalore, Karnataka, India.
BMJ Case Rep. 2021 Dec 3;14(12):e246534. doi: 10.1136/bcr-2021-246534.
Cystic hydatid disease or cystic echinococcosis (CE) is a globally endemic zoonosis caused by the larval cyst stage of the tapeworm Concomitant presence of CE and hepatocellular carcinoma (HCC) is a rare clinical scenario. A 70-year-old male patient presented with acute abdominal pain to the surgical outpatient department. On evaluation, a cystic lesion with solid components and free fluid in the abdomen was observed, which led to multiple differentials in the working diagnosis. A CT showed the mass to have a delayed enhancement. Surgical exploration revealed a partially ruptured hydatid cyst with daughter cysts in the abdominal cavity and a solid-component mass lesion. We proceeded with a right partial hepatectomy. Pathological evaluation revealed a pale mass lesion with a large collapsed cyst. HCC with unusual dense fibrillar fibrosis and cystic interface with normal parenchyma was observed. This case connects the multimodal assessment of radiology, surgery and pathology.
囊性包虫病或囊性包虫病（CE）是一种全球性流行的动物源性疾病，由绦虫幼虫期的囊状阶段引起。CE 和肝细胞癌（HCC）同时存在是一种罕见的临床情况。一名 70 岁男性因急性腹痛到外科门诊就诊。在评估中，观察到腹部有一个囊实性病变，伴有游离液体，这导致了多种不同的工作诊断。CT 显示肿块有延迟增强。手术探查显示部分破裂的包虫囊肿，腹腔内有子囊和实性成分肿块。我们进行了右半肝切除术。病理评估显示一个苍白的肿块病变，有一个大的塌陷的囊肿。观察到 HCC 具有不寻常的密集纤维状纤维化和与正常实质的囊性界面。这个病例连接了放射学、手术和病理学的多模态评估。
