Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 26, 2021; 9(3): 659-665
Published online Jan 26, 2021. doi: 10.12998/wjcc.v9.i3.659
Radical resection of hepatic polycystic echinococcosis complicated with hepatocellular carcinoma: A case report
Baheti Kalifu, Yuan Meng, Yusufukadier Maimaitinijiati, Zhi-Gang Ma, Guang-Lei Tian, Jin-Guo Wang, Xiong Chen
Baheti Kalifu, Yuan Meng, Yusufukadier Maimaitinijiati, Zhi-Gang Ma, Guang-Lei Tian, Jin-Guo Wang, Xiong Chen, Department of Hepatobiliary Surgery, People’s Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830001, Xinjiang Uygur Autonomous Region, China
Author contributions: Kalifu B and Maimaitinijiati Y designed and wrote the manuscript; Meng Y and Ma ZG performed the operation; Wang JG and Tian GL contributed to provision of study material; Chen X contributed to final approval of the version to be submitted; All authors have read and approve the final manuscript.
Supported by Project Plan of People’s Hospital of Xinjiang Uyghur Autonomous Region, No. 20190412 and No. 20190405.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised 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: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xiong Chen, MD, PhD, Doctor, Department of Hepatobiliary Surgery, People’s Hospital of Xinjiang Uygur Autonomous Region, No. 91 Tianchi Road, Urumqi 830001, Xinjiang Uygur Autonomous Region, China. 1512237458@qq.com
Received: September 2, 2020
Peer-review started: September 2, 2020
First decision: November 8, 2020
Revised: November 21, 2020
Accepted: December 6, 2020
Article in press: December 6, 2020
Published online: January 26, 2021
Processing time: 139 Days and 22 Hours
Abstract
BACKGROUND

Hepatic cystic echinococcosis (CE) is an infectious zoonotic parasitic disease, and the insidious onset and slow progression of hepatic CE usually contributes to delayed diagnosis and treatment. Hepatocellular carcinoma (HCC) is the fourth most common malignant tumor. Co-existence of CE and HCC is fairly rare in clinical settings and the association between the two is still not well recognized. We report a case of hepatic CE complicated with HCC which are radically resected and raise some questions worth thinking about.

CASE SUMMARY

A 70-year-old man presented with upper abdominal pain. On admission, laboratory data showed that, except for hepatitis B surface antigen positivity, other indicators were normal, including alpha-fetoprotein. Computed tomography of the abdomen revealed a huge polycystic lesion in left liver lobe, without reinforcement after enhanced scanning and sized about 16.9 cm × 12.2 cm, which was considered a type II hydatid cyst. Multiple small solid lesions were also found adjacent to it, and thus it was highly suspected as a malignant tumor. After a multidisciplinary team discussion, the diagnosis of co-occurrence of hepatic CE and HCC was made. According to Romic classification, the case belongs to type IIb, and radical left hemi-hepatectomy was performed. Postoperative pathological examination revealed CE co-existence with well-differentiated HCC, consistent with the preoperative diagnosis.

CONCLUSION

With the combination of hepatitis B and obvious extrusion by large hydatid, the HCC risk of a patient might be higher.

Keywords: Hepatocellular carcinoma; Cystic echinococcosis; Radical resection; Co-existence; Parasitic disease; Case report; Hepatitis B

Core Tip: Hepatic cystic echinococcosis (CE) is an infectious zoonotic parasitic disease, hepatocellular carcinoma (HCC) is the fourth most common malignant tumor. Co-existence of CE and HCC is fairly rare in clinical settings and the association between the two is still not well recognized. We report a case of hepatic CE complicated with HCC which are radically resected, and present an opinion that with the combination of hepatitis B and obvious extrusion by large hydatid, the HCC risk of the patients might be higher.