Postoperative Alveolar Hydatid Disease with Cutaneous‐Subcutaneous Involvement

Abstract

The first Japanese case of alveolar hydatid disease with cutaneous-subcutaneous lesions is reported. The patient, a 58-year-old man who developed an indurated subcutaneous tumor on the right side of the abdomen, had had partial hepatectomy of the right lobe for echinococcosis thirteen years earlier. Clinically, the tumor was adherent with a fistulosis communication to deeper structures. Histopathologically, multiple PAS-positive cuticular layers with foreign body granulomas and fibrosis were observed between the dermis and subcutaneous fatty tissue. Surgical excision of the swelling provided the patient with temporary relief. To our knowledge, only eight cases of subcutaneous alveolar hydatid disease have been reported throughout the world. Ours, the ninth case, highlights the importance and difficulty of treating of alveolar hydatid disease.

Hydatid Disease Presenting as Cutaneous Fistula: Review of a Rare Clinical Presentation

“…6 Any subcutaneous hydatid cyst is more likely to be a primary invasion of hepatic echinococcosis or contamination during previous surgery rather than hematogenous metastasis. 24 Surgical treatment combined with medical treatment to remove the cysts has good results in patients who are fit for the surgery. Surgical treatment includes resection of the primary cyst with excision of the fistula tract and diseased skin.…”

“…A Medline search in all languages using the keywords hydatid, cutaneous, and fistula revealed only 15 relevant cases. [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] We managed a case of spontaneous fistulization of a hydatid cyst through the umbilicus.…”

Hepatic infestation of Echinococcus multilocularis with extension to regional lymph nodes

“…), and surgical competence [10,19,20]. Because conservative treatment progressed and incomplete resections seem to lack of advantage, palliative surgery should be restricted to complications which are out of control for conservative or interventional measures, e.g., bacterial superinfection of necrosis (personal experience of the authors), vena cava occlusion, abscesses, symptoms related to space occupying mass, or fistula [7,[21][22][23][24][25]. Lifelong aftercare seems appropriate not only for conservatively treated patients but also after surgery because relapses were reported even 14 and 18 years after putative curative surgery [19,26].…”

Palliative operation for the treatment of alveolar echinococcosis

“…Rare indications for palliative resections -Palliative procedures for AE localized in the skin were scarcely reported (nine cases) and done as local excisions for diagnostics and cope with local complications [21][22][23]. -In a series of liver transplantation, the procedures were considered to be palliative in ten (9%) patients due to residual AE in lung or abdominal cavity [6].…”