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Case Reports
. 2021 Mar 20;21(1):150.
doi: 10.1186/s12893-021-01150-1.

Echinococcal hepatic lesion mimicking metastasis from colon cancer: two case reports

Marionna Cathomas  1 , Paolo Abitabile  2 , Rok Dolanc  3 , Christine Glaser  4 , Gieri Cathomas  5
Affiliations
Case Reports

Echinococcal hepatic lesion mimicking metastasis from colon cancer: two case reports

Marionna Cathomas et al. BMC Surg. .

Abstract

Background: Echinococcus is a worldwide zoonosis, primarily causing liver lesions. Accidentally detected, these lesions enter the differential diagnosis of a tumor, including metastasis. This situation is especially challenging in patients with colorectal cancer, as both diseases affect mainly the liver.

Case presentation: We report two patients with a newly diagnosed colorectal cancer. Pre- and intraoperatively radiological imaging revealed hepatic lesions which were resected on suspicion of colorectal cancer metastasis. Histology showed granulomatous lesions with characteristic parasitic membrane consistent with an echinococcal cyst. The diagnosis was confirmed by specific polymerase chain reaction.

Conclusions: Focal hypoechoic liver lesion in patients with colorectal cancer should be primarily considered as a liver metastasis and resected whenever feasible. Other uncommon etiologies, including parasitic lesion as echinococcal cysts, should be taken in consideration, as this could lead to major changes of the management and prognosis of the affected patients.

Keywords: Colorectal cancer; Echinococcal cyst; Echinococcus; Liver lesion; Metastasis.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
a Intraoperative ultrasound of the male patient with a hepatic lesion in segment V. b Preoperative computer tomography scan of female patient with a hepatic lesion in segment VI
Fig. 2
Fig. 2
The histology of the liver lesion shows a compact membrane and amorphic cystic content (H&E stain). Insert: Visualization of the characteristic Periodic-Acid-Schiff (PAS)-stain strongly positive membrane of the parasite. a male patient; b female patient
See this image and copyright information in PMC

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