Synchronous association of hepatocellular carcinoma and cystic echinococcosis with unusual pathology: report on diagnostic and pathological variability

Cystic hydatid disease or cystic echinococcosis (CE) is a globally endemic zoonosis caused by the larval cyst stage of the tapeworm Echinococcus granulosus. Concomitant presence of CE and hepatocellular carcinoma (HCC) is a rare clinical scenario. A 70-year-old male patient presented with acute abdominal pain to the surgical outpatient department. On evaluation, a cystic lesion with solid components and free fluid in the abdomen was observed, which led to multiple differentials in the working diagnosis. A CT showed the mass to have a delayed enhancement. Surgical exploration revealed a partially ruptured hydatid cyst with daughter cysts in the abdominal cavity and a solid-component mass lesion. We proceeded with a right partial hepatectomy. Pathological evaluation revealed a pale mass lesion with a large collapsed cyst. HCC with unusual dense fibrillar fibrosis and cystic interface with normal parenchyma was observed. This case connects the multimodal assessment of radiology, surgery and pathology.

Case Report on Hydatid Cysts with Hydropnemonothorax

Introduction: Hydatid disease is caused by a parasite infection induced by an echinococcus tapeworm. The hydatid cyst is one recognized cause of liver mass. It is a significant pathogenic, zoonotic, and parasitic illness (acquired from animals) of humans after consumption of tapeworm eggs produced in the faeces of infected dogs. Hydatid disease is a serious endemic health concern in various regions of the world. Cystic hydatid disease is most often associated with the liver (50–70%), although it can also affect the lung, spleen, kidney, bones, and brain. A hydropneumothorax occurs gradually. Case Presentation: A 35-year-old Man was taken to the Acharya Vinoba Bhave Rural Hospital with the chief complaint of abdominal discomfort, breathlessness (dyspnea) right side pain for 2 days. Approximately to the peritoneal cavity of the right chest by a hydatid cyst in the subscapular posterior part of the right lobe of the liver. For minimal ascites, a contrast study was conducted, revealing a multi-located hypodense cystic lesion spread across the abdomen was recognized as sign of hydatid disease. Conclusion: In a patient with a hydatid disease, physical and psychological therapy should be put together. In this study, we primarily focus on professional management and outstanding nursing care, which may give the comprehensive care that hydatid cyst requires. The complete health care team works together to assist the patient to restore his or her prior level of independence and happiness after a full recovery.

Surgical and anesthetic management of primary dumbbell shaped spinal hydatid cyst in lumbar vertebra: A rare case report

Hydatid cyst is a very significant health problem in India. As recorded in the literature, majority of hydatid cysts are found in the liver followed by the lungs with an incidence rate of 60-70% and 10-15% respectively. Cystic hydatid disease in bones is seen in less than 4% of cases, with majority presenting in the spine. In this case report we have discussed primary intraspinal extradural hydatid cyst with paravertebral extension (dumbbell shaped) in lumbar vertebra which is a rarity. The diagnosis was established intraoperatively based on the findings with a follow up and review of literatures, along with its management.

Seroprevalence of Human Cystic Echinococcosis in Sanandaj City, Kurdistan Province, Western Iran

Background and Aims: Echinococcus granulosus (E. granulosus) is a cestode parasite that causes cystic hydatid disease in humans worldwide. Iran is one of the endemic regions for infection that indicate the importance and presence of infection in this country. Therefore, the current research aimed to characterize the seroprevalence of human cystic echinococcosis in Sanandaj city, Kurdistan province, western Iran. Materials and methods: Totally, 500 serum samples were collected from patients referred to different health centers in Sanandaj city using cluster sampling in 2018-2019. All the sera were examined using the enzyme-linked immunosorbent assay test. Results: The seroprevalence of human hydatidosis was reported at 2.2% by ELISA test in Sanandaj city. This rate was 9 (1.9%) in women and 2 (0.4) in men. The age group of 20-30 years old had the highest positivity rate (1.0%). Also, the subjects that consumed home slaughtered meat had the highest infection rate at 4 (0.8%). There was no significant difference regarding factors studied such as sex, education, residence, consumed water, keeping a dog, and the seropositivity. Conclusions: Seroprevalence of human cystic echinococcosis in Sanandaj city is lower than the general prevalence in Iran. Our research team hopes to provide accurate data on the prevalence of hydatidosis in Sanandaj encourage more extensive research to help prevent this parasite in Iran and worldwide.

Scolicidal and Apoptotic Activities of 5-hydroxy-1, 4-naphthoquinone as a Potent Agent against Echinococcus granulosus Protoscoleces

Cystic hydatid disease (CHD) is a zoonotic disease with different clinical stages caused by the larval stage of the cestode Echinococcus granulosus. It is important to highlight as a public health problem in various regions of the world. In the current study, the efficacy and apoptotic activity of the liposomal system containing juglone (5-hydroxy-1,4-naphthoquinone) were assessed against protoscoleces (PSCs) in vitro. To this aim, firstly, liposomal vesicles were prepared by the thin-film method. Their physico-chemical features were assessed using Zeta-Sizer and Scanning Electron Microscope (SEM). Subsequently, various concentrations (50, 100, 200, 400, and 800 μg/mL) of juglone nanoliposomes at different exposure times (15, 30, 60, and 120 min) were used against PSCs. Results showed that juglone nanoliposomes at all tested concentrations induced scolicidal effect, however, 800 μg/mL and 400 μg/mL of juglone nanoliposomes could reach 100% mortality in 60 and 120 min, respectively. Additionally, we found that caspase-3 mRNA expression was higher in PSCs treated with juglone nanoliposomes compared to control groups (p < 0.001). Therefore, juglone nanoliposomes are suggested to have a more potent apoptotic effect on PSCs. Generally, optimized doses of juglone nanoliposomes could display significant scolicidal effects. Moreover, further in vivo studies are required to evaluate the efficacy of this nanoliposome.

Primary Disseminated Hydatid Disease Involving Multiple Organs in a Pediatric Patient: A Rare Case Report

Hydatid disease is a parasitic infestation by Echinococcus genus of tapeworm, resulting from ingestion of tapeworm eggs and leading to formation of cysts predominantly in the liver and lungs. Multiorgan involvement in children is unusual. We present a case of a 12-year-old female with multiple organ involvement. Patient had history of abdominal pain, breathlessness, irritability and vomiting. Plain radiograph showed a large ovoid calcific lesion projected over the liver. Abdominal sonography demonstrated multiple hydatid cysts in the liver, spleen and left kidney. Ultrasound findings were further confirmed by contrast-enhanced computed tomography that showed additional hydatid cysts in bilateral lungs. All accessible cysts were excised on laparotomy. Cystic hydatid disease should be suspected in all pediatric patients with multiple cystic lesions, especially in endemic areas.

RUPTURED HEPATIC HYDATID CYST : A RARE CASE REPORT

Hydatid cyst rupture into abdomen is a serious complication in cystic hydatid disease of liver. Both microscopic or macroscopic rupture can occur and it is fatal without surgery. It is primarily caused by tapeworm (ECHINOCOCCUS GRANULOSUS) and occurs worldwide with an incidence of 200/100,000in endemic areas. This is a case of 28 yr. female presenting with sudden onset pain abdomen since 4 days. Abdominal ultrasonography demonstrates ruptured hepatic hydatid cyst with free peritoneal fluid. She was managed in emergency operation theatre due to her clinical condition and exploratory laparotomy with omentopexy and toileting were done after fluid resuscitation, antihistaminic and corticosteroid treatment. Postoperatively she received antihelminthic treatment with Albendazol. She made a good recovery following surgery.

Cerebral Cystic Echinococcosis : A child with Giant Hydatid Cyst

Aim: Raising awareness of healthcare providers about headache and early morning vomiting in children. Background: Intracranial cystic hydatid disease (Echinococcosis) is a rare worldwide disease caused by encysted larvae of the dog tapeworm Echinococcus granulosa. Human is the intermediate host of this parasite and CNS involvement occurs in only 3%. Clinically, the cyst will cause seizure, increased intracranial pressure and/or focal neurological deficit. Surgical removal of the intact cyst by the Dowling technique is the treatment. A 4-year-old girl was referred to neurosurgery clinic with history of headache and early morning vomiting over the previous 2 months. Neurological examination revealed right hemiparesis and bilateral papilloedema. Emergency brain CT-scan revealed huge intracranial cystic lesion with midline shift. Emergency craniotomy was done and the cyst has been removed intact without complication and sent for histopathological examination. The patient has been discharged from the hospital with full recovery.

Cystic hydatid disease (Echinococcus granulosus)

Cystic hydatid disease, caused by Echinococcus granulosus, is a zoonotic disease principally transmitted between dogs and domestic livestock, particularly sheep. Humans are infected when they ingest tapeworm eggs, with disease occurring in most parts of the world where sheep are raised and dogs are used to herd livestock. The most common clinical manifestations are cysts in the liver (typically presenting with hepatomegaly) and/or lung (presenting with cough, haemoptysis, and dyspnoea). Diagnosis is usually made on the basis of serological tests in combination with imaging techniques. Treatment options include surgery, chemotherapy with anthelminthic agents, or—for liver cysts—PAIR (puncture–aspiration–injection–reaspiration). Echinococcosis is a major public health problem in several countries. Control programmes have been aimed at educating dog owners to prevent their animals from having access to infected offal. Vaccines against sheep hydatidosis and the dog tapeworm stage are promising alternatives.