A case of hepatic alveolar echinococcosis contracted in Belgium

We report herein the case of a Belgian 76-year-old woman who developed a hepatic tumour suspected to be a breast cancer metas- tasis. Radiological imaging and guided biopsies were not contribu- tive. The patient underwent an explorative laparoscopy with frozen sections that did not provide further diagnosis, and an open left bisegmentectomy was performed during the same anaesthesia. Histopathological examination of the hepatic mass showed Echinococcus multilocularis metacestodes, demonstrating alveolar echinococcosis. As our patient denied any travel in foreign coun- tries and has undergone regular abdominal ultrasonographies since her mastectomy, it is highly likely that this alveolar echinococcosis had been contracted in Belgium. If some imported cases may be seldom managed in Belgium, to our knowledge, this case is the first occurrence of alveolar echinococcosis contracted in Belgium. This report, added to the demonstration of E. multilo- caris infection of 50% of red foxes in Southern Belgium, and the potential infection of domestic cats and dogs, should attract atten- tion of the medical community on the possible outbreak of endem- ic alveolar echinococcosis in Belgium, and on the related public health concerns. (Acta gastroenterol. belg., 2002, 65, 55-60).