Presentation of an unusual case of hepatic alveolar echinococcosis : multi- detector CT and US findings

A 40 year old male farmer admitted to internal medi- cine clinic with post prandial dyspnea and excessive sweating lasting for the last two months. In his physical examination, hepatosplenomegaly and right upper quad- rant tenderness were detected. He had no jaundice or pruritus. His liver function tests were elevated with nor- mal bilirubin levels. He was referred to our department for Ultrasound (US) examination which revealed multi- ple well defined, nodular, homogeneous lesions isoe- choic with the liver parenchyma and with surrounding hypoechoic rims (Fig. 1a). Further evaluation with abdominal Computed Tomography (CT) demonstrated a total of six masses in both lobes of the liver. The largest of them located at segment 7 was 10 cm to 7.5 cm.