Volume 65 - 2002 - Fasc.1 - Case reports
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).
Endoscopic removal of a pedunculated early duodenal cancer : diagnostic value of endoscopic ultrasound
A 79-year-old Japanese woman was admitted to our hospital for evaluation of a polypoid lesion in the second portion of the duode- num. Radiographic and endoscopic examinations of the upper gastrointestinal tract indicated that this mass was pedunculated and had a nodular surface. Endoscopic ultrasonography demon- strated a hypoechoic tumor limited to the mucosa without lymph node involvement. Endoscopic polypectomy was performed. Histologic examination showed a tubular adenocarcinoma arising in an adenoma with invasion limited to the mucosa. Findings were consistent with complete endoscopic resection. Follow-up over a 12-month period has disclosed no evidence of tumor recurrence. Endoscopic polypectomy using information from endoscopic ultrasonography would appear to be a safe and effective method for diagnosis and treatment of pedunculated early duodenal can- cers. (Acta gastroenterol. belg., 2002, 65, 52-54)
