Xu Xiaolei, Gao Cancan, Qian Xinye, Liu Hong'en, Wang Zhan, Zhou Hu, Zhou Ying, Wang Haijiu, Hou Lizhao, He Shaoshuai, Feng Xiaobin, Fan Haining
Department of Hepatobiliary and Pancreatic Surgery, Qinghai University Affiliated Hospital, Xining, China.
Center of Hepatobiliary Pancreatic Disease, Beijing Tsinghua Changgung Hospital, Beijing, China.
Front Oncol. 2022 Mar 24;12:849047. doi: 10.3389/fonc.2022.849047. eCollection 2022.
Echinococcosis is a human-animal parasitic disease caused by Echinococcosis tapeworm larvae in humans. From a global perspective, it is mainly prevalent in the mid-high latitudes of the Northern Hemisphere, and it is a widespread infectious disease. Its form, host and release areas are slightly different. In clinical practice, (hepatic cystic echinococcosis) is the most common. Its growth mode is swelling growth and its metastasis is more common in implanted metastasis; However, hepatic alveolar echinococcosis (HAE) is rare. It has been reported that HAE can metastasize through the blood or lymph nodes, and its invasive growth pattern is known as "carcinoma". At this time, it may be accompanied by invasion of the portal vein and inferior vena cava(IVC)or metastasis to distant organs outside the liver (such as lung, brain, lymph nodes). Most patients are in the middle or late stages, making treatment complicated. World Health Organization guidelines recommend radical resection of HAE; However, there is no consensus on lymph node dissection. To date, there have been no reports of cases of HAE accompanied by inferior vena cava-para-abdominal aortic suspected lymph node metastasis and infection. This article reports a clinical case of a complex HAE treated by the surgical method of "middle liver resection + abdominal enlarged lymph node resection + inferior vena cava repair", and histological examination was performed to illustrate the differences in microscopic pathology of alveolar echinococcosis invading the liver and lymph nodes at different magnifications. This article reviews the relevant literature on HAE and derives the latest treatment methods for HAE to provide a reference for future clinical cases of similar alveolar echinococcosis and maximize the benefits of patients.
包虫病是一种由棘球绦虫幼虫在人体引起的人畜共患寄生虫病。从全球范围来看，它主要流行于北半球的中高纬度地区，是一种广泛传播的传染病。其形态、宿主及发病地区略有不同。在临床实践中，（肝囊型包虫病）最为常见。其生长方式为膨胀性生长，转移方式多为种植转移；然而，肝泡型包虫病（HAE）较为罕见。据报道，HAE可通过血液或淋巴结转移，其浸润性生长方式被称为“癌性”。此时，可能伴有门静脉和下腔静脉（IVC）侵犯或肝外远处器官（如肺、脑、淋巴结）转移。大多数患者处于中晚期，治疗复杂。世界卫生组织指南建议对HAE进行根治性切除；然而，对于淋巴结清扫尚无共识。迄今为止，尚无HAE伴有下腔静脉-腹主动脉旁可疑淋巴结转移及感染的病例报道。本文报道了一例采用“肝中叶切除+腹部肿大淋巴结切除+下腔静脉修补”手术方法治疗的复杂HAE临床病例，并进行了组织学检查，以说明不同放大倍数下泡型包虫病侵犯肝脏和淋巴结的微观病理学差异。本文回顾了关于HAE的相关文献，得出HAE的最新治疗方法，为未来类似泡型包虫病的临床病例提供参考，使患者受益最大化。
