Hepatic hydatid cyst

Case contributed by Mahomed A. Osman
Diagnosis almost certain

Presentation

Abnormal liver function tests and right upper quadrant pain.

Patient Data

Age: Adult
Gender: Male
mri

There is a large fluid filled cysts within the liver, containing multiple septations. Some smaller satellite cysts are also demonstrated, most numerous at the superomedial aspect of the parent cyst. Findings are consistent with a hepatic hydatid cyst.

There is evidence of mass effect on the intrahepatic IVC which demonstrates moderate luminal narrowing as a result.

Case Discussion

Hydatid cysts occur secondary to infection with a parasitic worm of the genus Echinococcus. These cysts are most commonly found intrahepatically but may also be seen in the lungs and other solid viscera such as the spleen.

They characteristically are quite large, with mixed attenuation within (depending on the composition of the cyst fluid) and will often demonstrate peripheral calcification of the wall, with or without septations, daughter cysts within the parent cyst and/or satellite cysts. Their walls demonstrate contrast enhancement on both CT and MRI.

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