Hu YW, Zhao YL, Yan JX, Ma CK. Coexistence of liver abscess, hepatic cystic echinococcosis and hepatocellular carcinoma: A case report. World J Clin Cases 2024; 12(14): 2404-2411 [PMID: 38765738 DOI: 10.12998/wjcc.v12.i14.2404]
Corresponding Author of This Article
Cun-Kai Ma, MD, Chief Physician, Department of Interventional Therapy, The Affiliated Hospital of Qinghai University, No. 29 Tongren Road, Xining 810000, Qinghai Province, China. qhdxmacunkai@qq.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. May 16, 2024; 12(14): 2404-2411 Published online May 16, 2024. doi: 10.12998/wjcc.v12.i14.2404
Coexistence of liver abscess, hepatic cystic echinococcosis and hepatocellular carcinoma: A case report
Ya-Wen Hu, Yi-Lin Zhao, Jing-Xin Yan, Cun-Kai Ma
Ya-Wen Hu, Yi-Lin Zhao, Cun-Kai Ma, Department of Interventional Therapy, The Affiliated Hospital of Qinghai University, Xining 810000, Qinghai Province, China
Jing-Xin Yan, West China Hospital, Sichuan University, Chengdu 610000, Sichuan Province, China
Co-first authors: Ya-Wen Hu and Yi-Lin Zhao.
Author contributions: All authors collected the data from medical records, contributed to the design of the study, and wrote the first draft of the manuscript. Hu YW and Yan JX contributed to the conception and design of the study; Zhao YL and Ma CK provided clinical evaluation and treatment for the patient. All the authors contributed to manuscript revision, and read and approved the submitted version.
Informed consent statement: All study participants provided informed written consent prior to study enrollment.
Conflict-of-interest statement: No potential conflicts of interest were reported by the author(s).
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Cun-Kai Ma, MD, Chief Physician, Department of Interventional Therapy, The Affiliated Hospital of Qinghai University, No. 29 Tongren Road, Xining 810000, Qinghai Province, China. qhdxmacunkai@qq.com
Received: January 11, 2024 Revised: February 7, 2020 Accepted: April 3, 2024 Published online: May 16, 2024
Abstract
BACKGROUND
Human cystic echinococcosis (CE) is a life-threatening zoonosis caused by the Echinococcus granulosus (sensu lato). Hepatocellular carcinoma (HCC) is a leading cause of cancer-related mortality in the world. The coexistence of CE and HCC is exceedingly rare, and only several well-documented cases have been reported. In addition to this coexistence, there is no report of the coexistence of CE, HCC, and liver abscess to date. Herein, we aimed to report a case of coexistence of liver abscess, hepatic CE, and HCC.
CASE SUMMARY
A 65-year-old herdsman presented to the department of interventional therapy with jaundice, right upper abdominal distension and pain for 10 d. Laboratory test showed that he had positive results for HBsAg, HBeAb, HBcAb, and echinococcosis IgG antibody. The test also showed an increased level of alpha fetoprotein of 3400 ng/mL. An abdominal computed tomography (CT) scan revealed an uneven enhanced lesion of the liver at the arterial phase with enhancement and was located S4/8 segment of the liver. In addition, CT scan also revealed a mass in the S6 segment of the liver with a thick calcified wall and according to current guideline and medical images, the diagnoses of hepatic CE (CE4 subtype) and HCC were established. Initially, transarterial chemoembolization was performed for HCC. In the follow-up, liver abscess occurred in addition to CE and HCC; thus, percutaneous liver puncture drainage was performed. In the next follow-up, CE and HCC were stable. The liver abscess was completely resolved, and the patient was discharged with no evidence of recurrence.
CONCLUSION
This is the first reported case on the coexistence of liver abscess, hepatic CE, and HCC. Individualized treatment and multidisciplinary discussions should be performed in this setting. Therefore, treatment and diagnosis should be based on the characteristics of liver abscess, hepatic CE, and HCC, and in future clinical work, it is necessary to be aware of the possibility of this complex composition of liver diseases.
Core Tip: This is the first reported case of coexistence of liver abscess, hepatic cystic echinococcosis (CE) and hepatocellular carcinoma (HCC). Transarterial chemoembolization was performed for HCC and percutaneous liver puncture drainage was then performed to relieve the liver abscess. The subtype of CE is CE4, as its blood supply is exceedingly poor, so wait-and-watch can be used in this setting. Individualized treatment and multidisciplinary discussions should be performed in this setting.
