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Case of the Week 366

What's the most likely diagnosis?

  • 51 year-old male with mild RUQ pain

Contrast-enhanced axial CT of upper abdomen

  1. Auto-infarction of spleen
  2. Hydatid liver cyst
  3. Cirrhosis
  4. Rupture of the diaphragm
  5. Carcinoma of the stomach

Additional Image - Coronal CT reconstruction


Additional Image


Coronal CT reformatted image of abdomen



3. Hydatid Liver Cyst



More (Click Discussion Tab)

Hydatid Cyst of Liver

General Considerations

  • Parasitic infestation caused by Echinococcus tapeworm
  • Endemic to Middle East, Africa, Iceland, Australia, southern parts of South America
    • Very rare in US
  • Cysts grow slowly and usually don’t become symptomatic until adulthood (30-50 years old)
  • Three species which cause human disease are
    • E. granulosus (aka granulosa, granulosis) causes Cystic Echinococcosis (CE) (most common)
    • E. multilocularis causes Alveolar Echinococcosis (AE) –most virulent
    • E. vogeli—rarest
  • Infestation of humans, who are accidental intermediate hosts, occurs from ingestion of water or food contaminated by fecal material of definitive hosts (dogs, wolves, deer, sheep, coyotes)
    • Eggs hatch in duodenum and pass as larvae through intestinal wall into blood stream to liver and lungs

    More ...


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