Case 214:   Echinococcosis, cystic (hydatid)

Diagnostic Category:

Clinical Presentation:

47 year old woman with right upper quadrant pain and anorexia.

US: WHO type CE4: multivesicular complex cyst

Imaging Findings:

Ultrasound demonstrates complex solid-cystic multivesicular hydatid cyst WHO classification type CE4 in segment 8 with round daughter cysts, collapsed endomembrane and debris forming a pseudotumor. Note that ultrasound demonstrates more details in this cyst than CT does, allowing for the characterization of hydatid cyst - WHO type CE4 (cyst is WHO type CE3 by CT features).

Smaller exophytic hydatid cyst in the left lobe (third image) is WHO type 3 with collapsed endocyst, corresponding to findings on CT.

Courtesy Dr. Pelin Seher Oztekin, Ankara Training and Research Hospital, Department of Radiology, Ankara, Turkey and Dr. Ayse Secil Eksioglu, Dr. Sami Ulus Women and Children's Hospital, Department of Radiology, Ankara, Turkey.