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. 2017:31:79-82.
doi: 10.1016/j.ijscr.2017.01.017. Epub 2017 Jan 10.

Huge echinococcal cyst of the liver managed by hepatectomy: Report of two cases

Efstathios T Pavlidis  1 , Nikolaos Symeonidis  2 , Kyriakos Psarras  1 , Theodoros E Pavlidis  1
Affiliations

Huge echinococcal cyst of the liver managed by hepatectomy: Report of two cases

Efstathios T Pavlidis et al. Int J Surg Case Rep. 2017.

Abstract

Introduction: Echinococcocal cysts are predominantly located in the right liver. They are usually solitary and asymptomatic, but large cysts can cause compression symptoms.

Case reports: We report two cases of huge (25cm and 20cm in diameter, respectively) echinococcal cysts located in the left liver, which presented as a large palpable mass causing compression symptoms. Diagnosis was established with CT scan showing a cystic mass with the characteristic daughter cysts and reactive layer (pericystic wall) consisting of fibrous connective tissue and calcifications. Both patients were treated radically with left hepatectomy and had uneventful postoperative course and no recurrence upon follow-up.

Discussion: The treatment of liver echinococcal cysts represent a unique surgical challenge. Even though conservative approaches are less technically demanding, the radical approach with resection has better outcome with less recurrences, when performed by experienced surgeons.

Conclusion: Resection rather than drainage is the management of choice for such huge liver echinococcal cysts.

Keywords: Echinococcal cyst; Echinococcosis; Hepatectomy; Hepatic hydatid disease; Liver cysts.

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Figures

Fig. 1
Fig. 1
CT showing the huge cyst (25 cm) with the characteristic daughter cysts and clearly delineated reactive layer (pericystic wall) in the first case.
Fig. 2
Fig. 2
CT showing the huge cyst (20 cm) with the characteristic daughter cysts and clearly delineated reactive layer (pericystic wall) in the second case.
Fig. 3
Fig. 3
Intact the resected specimen showing thickened the outer or adventitia fibrous layer of hitine in the first case.
Fig. 4
Fig. 4
Opened the huge cyst with contained daughter cysts and vesicles, hydatid debris material, the inner laminated or germinal membrane and clear water fluid in the first case.
Fig. 5
Fig. 5
CT showing the liver remnant one month after hepatectomy and no other abnormal findings in the first case.
Fig. 6
Fig. 6
CT showing the liver remnant with compensatory hyperplasia seven months after hepatectomy and no recurrence or other abnormal finding in the first case.
See this image and copyright information in PMC

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