Multiorgan resection with inferior vena cava reconstruction for hepatic alveolar echinococcosis: A case report and literature review

Abstract

Alveolar echinococcosis (AE) is a life-threatening parasitic disease characterized by its tumor-like growth. Radical operation is deemed the curable method for AE treatment if R0-resection is achievable. We present a 26-year-old AE patient with AE lesions invading the right lobe of the liver, the inferior vena cava, inferior lobe of right lung, the right hemidiaphragm, and the right kidney. On the basis of precise preoperative and intraoperative evaluations, a radical surgery that removed the huge lesion en bloc was performed successfully with skillful surgical techniques. This patient had an uneventful postoperative recovery and a good prognosis. Multiorgan resection is justified and unavoidable in selected patients when AE lesions invade different organs and the main vascular structures.

Figure 1

(A–C) Enhanced CT indicated a huge mass of 18 cm in diameter, which was in the right lobe of the liver with IVC and the right kidney invasion. The black arrays: IVC. The white array: portal vein. (D) The parasitic lesion in the right liver. (E) Repair the diaphragm with Dacron patches. (F) Reconstruct the IVC by an end-to-end anastomosis with an ePTFE graft, the array: ePTFE graft.

Figure 2

The CT scan at 15 days after the surgery indicated a patent IVC with no obstruction.

Figure 3

Hematoxylin and eosin stain of paraffin sections. (A, B) Histopathology of liver lesion (magnification of A: 200, B: 400). (C, D) Histopathology of the kidney lesion (magnification of C: 200, D: 400). The arrows: AE.