A Case of Hepatic Alveolar Echinococcosis Treated Radically by Hepatectomy 29 Years after Infection by Echinococcus Multilocularis

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  • MATSUDAIRA Shinichi
    Department of Hepatobiliary-Pancreatic Surgery, Juntendo University School of Medicine
  • ISHIZAKI Yoichi
    Department of Digestive and General Surgery, Juntendo University Urayasu Hospital
  • YOSHIMOTO Jiro
    Department of Hepatobiliary-Pancreatic Surgery, Juntendo University School of Medicine
  • IMAMURA Hiroshi
    Department of Hepatobiliary-Pancreatic Surgery, Juntendo University School of Medicine
  • FUKUMURA Yuki
    Department of Diagnostic Pathology, Juntendo University School of Medicine
  • KAWASAKI Seiji
    Mitsui Memorial Hospital

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Other Title
  • 感染後29年の経過が推定された肝多包性エキノコックス症の1例
  • 症例 感染後29年の経過が推定された肝多包性エキノコックス症の1例
  • ショウレイ カンセン ゴ 29ネン ノ ケイカ ガ スイテイ サレタ カン タホウセイ エキノコックスショウ ノ 1レイ

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A 31-year-old woman living in Chiba prefecture visited a medical clinic with a history of abdominal pain and diarrhea. Abdominal CT showed multiple cystic lesions in the liver. The serological test for anti-echinococcal antibody was positive, confirming the diagnosis of alveolar echinococcosis of the liver, and the patient was referred to our department. The CT images revealed multiple cystic lesions in segments 3/2, 5, 7/8, and 8, and the lesion in segment 8 was adjacent to the right hepatic vein. Extended posterior segmentectomy, including concomitant resection of the right hepatic vein, left lateral segmentectomy and partial hepatectomy (S5), was performed. The postoperative course was uneventful, and the patient was discharged on the 18th day after surgery. Histopathological examination revealed epithelioid granulomas and large necrotic lesions in the cysts. The necrotic lesions were associated with microcysts having a cuticular layer and protoscoleces with brood capsules. At present, three years since the surgery, the patient remains alive without recurrence. Although she lives in the Kanto area, she had a history of travel to Hokkaido and of contact with foxes when she was 2 years old. We report a case of alveolar echinococcosis of the liver, in which the disease showed slow progression over 29 years after the infection by echinococcus multilocularis.

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