This case shows an echinococcal liver abscess with imaging features of a complex liver lesion that has a cystic component, without characteristic imaging features of an echinococcal cyst (like daughter cysts or water lily sign). The patient history of exposure for sheep and dogs was suggestive for the diagnosis. However, due to borderline serology and lack of specific imaging findings, the diagnosis was done based on tissue sampling.

Courtesy of Shady Kasis.