Hepatocellular Carcinoma Complicated by Echinococcal Cyst: A Case Report

Abstract

Hepatocellular carcinoma (HCC), combined with hepatic hydatid disease, is a rare clinical case, having certain specificity in clinical diagnosis and treatment. We report a case of HCC combined with hepatic hydatid disease treated in our clinic to arouse the attention of clinicians to the disease. A 54-year-old female patient was admitted to the clinic on October 31, 2016 because of “Intermittent upper abdominal pain and discomfort for 1 month.” Abdominal CT in the previous hospital showed liver space-occupying lesions, and hepatic hydatid disease should be considered. The patient had a history of hepatitis B virus (HBV) infection since childhood but has not received antiviral treatment. She did have a history of life in pastoral areas. Laboratory examination results were as follows: alpha-fetoprotein (AFP) 1,210 ng/ml, HBV DNA: 5.32E + 3 IU/ml. Casoni test was positive. Enhanced CT of abdomen suggestion was: malignant liver tumor, hepatic hydatid disease. Gastroscopy and colonoscopy showed no abnormalities. She underwent an operation on November 10, 2016. Segment 5, 8 of hepatic, echinococcus internal capsule, and cholecyst were all removed. She took albendazole (0.4 g/day) for 6 months and oral entecavir (0.5 mg/day) antiviral treatment for a long time after surgery. From May 2017 to October 2019, a total of 5 cycles of transarterial chemotherapy embolization (TACE) were performed. The patient underwent surgical treatment, followed by TACE, antiviral therapy, and sequential albendazole treatment. The AFP level increased significantly, but there was no obvious recurrence of HCC in imaging.

Hepatocellular Carcinoma Presenting Simultaneously with Echinococcal Cyst Mimicking a Single Liver Lesion in a Non-Cirrhotic Patient: A Case Report and Review of the Literature

“…Although both HCC and CE are common liver lesions with high incidence rates in the general population, their synchronous occurrence is very rare in clinical practice, especially in a non-cirrhotic liver [ 6 , 7 , 8 , 9 ]. Thus, in a recent study among 3300 patients with CE, the concomitant presence of HCC was found in only 13 cases (0.39%) [ 8 ].…”

“…With the popularization of tourism and migration of the population, CE is no longer just an endemic disease, but it has become a global health problem worldwide [ 4 ]. Even though both HCC and liver echinococcosis are common diseases, their coexistence, especially in the form of a coalescent lesion in a non-cirrhotic liver, is very rare in clinical practice [ 6 , 7 , 8 , 9 , 10 , 11 ]. The association between these two diseases is still not well-defined, with many contradictory reports in the previous literature [ 12 , 13 , 14 ].…”

Misdiagnosis of hepatic cystic echinococcosis complicated with hepatocellular carcinoma: A case report

“…Hepatic CE is widely distributed around the world in areas with developed agriculture and animal husbandry, and most commonly settles in the liver. [ 5 ] Various treatments like drug therapy, puncture, aspiration, injection, and reaspiration are applied to clinical practice, but the traditional surgical resection is still the main treatment. Although hepatic CE is relatively common in clinical practice, CE combined with liver cancer is rare in clinical practice, especially for some atypical cases, which is more difficult to diagnose.…”

A rare case of hepatic hydatid cyst in Somalia: a case report

“…Hydatid can involve any organ. The liver and lungs are the most frequently affected sites [4,5]. Hepatic hydatid is a life-threatening disease, mainly differentiated into cystic and alveolar forms, associated with infections of E. granulosus and E. multilocularis, respectively.…”