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Review
. 2009 Oct;24(10):1161-5.
doi: 10.1007/s11606-009-1062-1. Epub 2009 Jul 25.

Differential diagnosis and management of a recurrent hepatic cyst: a case report and review of literature

Kurt Scherer  1 , Nishant Gupta, Winston P Caine, Mukta Panda
Affiliations
Review

Differential diagnosis and management of a recurrent hepatic cyst: a case report and review of literature

Kurt Scherer et al. J Gen Intern Med. 2009 Oct.

Abstract

Echinococcus granulosus, which causes cystic echinococcosis, is an uncommon condition in the United States. We report a case of a 78-year-old Caucasian female who presented to her primary care physician in 1999 with right upper quadrant pain. She had a history of frequent foreign travel. Abdominal imaging demonstrated a 12.5-cm hepatic cyst. The cyst was drained and the pathology report on the fluid indicated no bacterial, parasitic, or malignant etiology. Serology tests for Entamoeba and Echinococcus antibodies were negative. The patient underwent multiple hepatic cyst aspirations until 2008 for recurring symptoms. In 2008, abdominal imaging demonstrated solid internal components within the cyst. Repeat Echinococcus antibodies ordered were abnormally elevated. Cyst aspiration demonstrated Echinococcus protoscolex. We report this case to discuss the diagnosis and management of hydatid cyst and to emphasize that with increasing globalization, physicians must maintain a high index of clinical suspicion for parasitic etiologies in patients with hepatic cysts.

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Figures

Figure 1
Figure 1
Abdominal ultrasound May 2008. Inferior right hepatic lobe 13 × 12.7 × 11.4 cm cystic lesion with solid internal components (arrow).
Figure 2
Figure 2
Abdominal computed tomography scan May 2008. Right hepatic cyst unchanged since prior examinations (arrow).
Figure 3
Figure 3
Acid fast bacillus stain June 2008. Degenerating (arrow).
See this image and copyright information in PMC

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