Alveolar Echinococcosis Mimicking a Hepatic Neoplasm with Lymph Node Metastasis: A Case Report

Amano, Takahiro; Hayashi, Shiro; Nishida, Tsutomu; Matsubara, Tokuhiro; Takahashi, Kei; Nakamatsu, Dai; Tomimaru, Yoshito; Yamamoto, Masashi; Nakajima, Sachiko; Fukui, Koji; Tamura, Hiromi; Adachi, Shiro; Dono, Keizo; Inada, Masami

doi:10.1159/000492461

Cited by 9 publications

(17 citation statements)

References 13 publications

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“…Our data once more illustrate the difficulty in the diagnosis and therapy of hepatic AE. Due to a resemblance of the radiologic features in liver imaging between cholangiocellular carcinoma and AE, misdiagnosis has been reported earlier as a pitfall for this disease [2,10,23,24]. In our study group, the initial indication for major liver resection was suspected intrahepatic cholangiocellular carcinoma in 2 out of 12AE patients.…”

Section: Discussionmentioning

confidence: 72%

Exploring the limits of hepatic surgery for alveolar echinococcosis—10-years’ experience in an endemic area of Austria

et al. 2019

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Background Hepatic alveolar echinococcosis is a slow-growing, destructive parasitosis for which radical surgical resection is currently the only curative treatment. In case of complications by infiltrated vascular or biliary structures, interventional techniques are used. Pharmacotherapy is recommended postoperatively and for inoperability. The rare zoonotic occurs in the northern hemisphere and still poses a challenge in diagnostic and therapeutic management. Based in an endemic area in Austria, we evaluated a decade of surgical treatment for alveolar echinococcosis (AE) at our department. Methods Clinical data of patients undergoing hepatic resection for AE at our department between 2005 and 2014 were collected. Every diagnosis was again verified by histology and PCR. The PNM staging of preoperative imaging was done in six-eye principle. This study was approved by the local Ethics Committee of The authors Stefanie Kuscher and Irmgard Elisabeth Kronberger contributed equally to the manuscript.

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Section: Discussionmentioning

confidence: 72%

Exploring the limits of hepatic surgery for alveolar echinococcosis—10-years’ experience in an endemic area of Austria

et al. 2019

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“…"Hydatid cells" or germinal cells are transferred to regional lymph nodes through lymphatic reflux (3). Suspicious metastasis of peripancreatic lymph node in hepatic alveolar echinococcosis was already reported (8).…”

Section: Discussionmentioning

confidence: 99%

Suspected Regional Lymph Node Metastasis in Hepatic Alveolar Echinococcosis: A Case Report

Wang

Chen

Ren

et al. 2020

IJPA

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There is no direct evidence to support the existence of regional lymph node metastatic routes in hepatic alveolar echinococcosis, and only a few literature have been reported. There was a case of hepatic alveolar echinococcosis suspected of metastasis of regional lymph node in Clinical Center for Hydatidosis, Qinghai Province, China. The patient was a 24-yr-old male from pastoral area of Seda County, Sichuan Province, China in 2018. He was admitted to the hospital for physical examination and had no special discomfort. Preoperative examination showed liver occupancy and regional lymph node enlargement in the space between liver and stomach. Hepatectomy and lymph node resections were performed. Postoperative pathological results showed that both primary and metastatic lesion were of alveolar echinococcosis. Recovery of patient was good without complications and recurrence. In this case, metastasis was considered because the liver lesion was not directly connected to the lymph node. However, the case was still suspected due to the lack of pathological examination of other lymph nodes in the lymphatic return pathway. Regional lymph node metastasis may be one of the metastatic ways of alveolar echinococcosis.

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“…In 2009, Klaus et al [24] con rmed for the rst time that a patient with AE had regional lymph node involvement. Subsequently, some cases were gradually reported, but all lacked data regarding the incidence and long-term follow-up conclusions [7,8,12,13,25] (Table 2). In 2018, a retrospective analysis [26] of 46 patients in this center found that 7 patients had AE lymph node involvement and proposed that lymph node involvement was not associated with recurrent disease.…”

Section: Discussionmentioning

confidence: 99%

“…If lymph node metastasis is suspected, and puncture should be performed cautiously. EUS-FNA is a good diagnostic tool, but it should be used when the diagnosis is unclear and the patient is from a nonendemic area [8,25]. Pathological diagnosis is the gold standard.…”

Section: Discussionmentioning

confidence: 99%

Relevance of Regional Lymph Node Invasion in Radical Hepatectomy and Lymphadenectomy for Alveolar Echinococcosis: A Retrospective Cohort Study

Wang

Shen

Wang

2020

Preprint

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Background Hepatic Alveolar echinococcosis (AE) is also known as worm cancer, parasitic cancer, and it often invades the regional lymph nodes of the liver. The present study was to investigate the clinical value of radical hepatectomy and lymphadenectomy in AE patients. Methods Our study enrolled consecutive AE patients who underwent radical hepatectomy with removal the regional lymph nodes between January 2009 and April 2019. Patients with inflammatory lymph node enlargement was included in group A, and patients with AE lymph node invasion were included in group B. The clinical characteristics, survival and recurrence rates were compared.Results A total of 103 patients were enrolled group A, and 24 in group B. Preoperative computed tomography showed that the lymph node positivity rate in group B was 70.8% while that in group A was 43.7% (p=0.017). The lymph node diameter was 1.8±0.9 cm in group A vs 2.5±1.1 cm in group B (p=0.004), and the lymph node number (p=0.035) and lymph node location (p=0.001). A total of 10 patients (7.9%) had recurrent lesions, and 6 patients (4.7%) died (P>0.05). Conclusions lymph node diameter, number, and distance from the liver were important characteristics for describing lymph node invasion. There was no difference in the long-term efficacy of lymphadenectomy between patients with lymph node enlargement and those with invasion.

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Alveolar Echinococcosis Mimicking a Hepatic Neoplasm with Lymph Node Metastasis: A Case Report

Cited by 9 publications

References 13 publications

Exploring the limits of hepatic surgery for alveolar echinococcosis—10-years’ experience in an endemic area of Austria

Exploring the limits of hepatic surgery for alveolar echinococcosis—10-years’ experience in an endemic area of Austria

Suspected Regional Lymph Node Metastasis in Hepatic Alveolar Echinococcosis: A Case Report

Relevance of Regional Lymph Node Invasion in Radical Hepatectomy and Lymphadenectomy for Alveolar Echinococcosis: A Retrospective Cohort Study

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