Presentation
History of melanoma on the skin. CT was performed for staging.
Patient Data
In the liver left lobe totally and segments V and VIII there are three inhomogeneous hypodense masses surrounded by numerous small cysts (up to 5-8 mm in diameter), which are located mainly on the periphery; the structure of these formations is heterogeneous with the fine dense inclusions in the center (calcification). The diameter of the masses is up to 65-72 mm. These formations are hypovascular and squeeze vessels in the gates of the liver; the portal vein runs along the edge of one of them without visible invasion/thrombosis of the vessel; later the branches of the portal vein on both sides bend the formations.
Intraoperative photography and histology confirm the diagnosis - Hepatic alveolar echinococcosis.
Case Discussion
It is known that the patient traveled to Siberia.
The masses in both lobes of the liver have characteristic imaging features of hepatic alveolar echinococcosis, which was further confirmed intraoperatively.
This condition represents a rare parasitic disease occurring after ingestion of Echinococcus multilocularis eggs and is clinically characterized by an initial asymptomatic incubation period of many years, followed by a chronic course, in which clinical manifestations, include epigastric pain and jaundice.
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