Simultaneous Echinococcal Cyst and Hepatocellular Carcinoma Without Underlying Liver Disease

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We report the rare simultaneous presence of an echinoccocal cyst and hepatocellular carcinoma (HCC) in a 65-year-old woman without underlying liver disease. She presented to the emergency department complaining of pain in the right upper abdominal quadrant of four months’ duration. Accompanying manifestations included weight loss, diaphoresis, and intermittent fever. Her past medical history did not suggest chronic liver disease. A CT scan was performed first and yielded unclear findings; MRI revealed a centrally located liver tumor (HCC), stellate in shape, measuring 9.5 × 7.3 cm, and infiltrating the sixth, seventh, and (partly) eighth hepatic segments. In the eighth segment, there was also an elongated, septated and calcified lesion measuring 11 × 4 cm, whose appearance was consistent with an echinococcal cyst. The two lesions were not in contact and there was no evidence of hepatic cirrhosis on examination or on diagnostic testing. The serum level of α-fetoprotein (a tumor marker) was elevated (346 ng/mL), and a serological test for echinococcosis was positive.

Dr. med. Ivan Romic, Dr. med. Bosko Romic, Dr. med. Igor Petrovic, University Hospital Centre Zagreb, Croatia, [e-mail]

Conflict of interest statement
The author declare that no conflict of interest exists.

Cite this as: Romic I: Simultaneous echinococcal cyst and hepatocellular carcinoma without underlying liver disease. Dtsch Arztebl Int 2016; 113: 846. DOI: 10.3238/arztebl.2012.0846