Misdiagnosis of hepatic cystic echinococcosis complicated with hepatocellular carcinoma: A case report

Hepatic cystic echinococcosis (CE) is a common zoonotic parasitic disease caused by the entry of Echinococcus granulosus eggs into human body. Surgical resection is the optimal treatment choice for hepatic CE. However, Coexistence of CE and hepatocellular carcinoma (HCC) have been reported with a rare incidence rate, which led to unsatisfactory prognosis after the operation. PATIENT CONCERNS: A 69-year-old male patient was admitted to hospital because of “Upper abdominal pain and discomfort for more than 1 month and an aggravation for 10 days.” DIAGNOSIS: An elderly male herder who was initially diagnosed as hepatic CE, and none of the preoperative imaging test revealed the existence of HCC. Co-existence of hepatic CE and HCC was confirmed by the postoperative pathological examination. INTERVENTIONS: The patient underwent “combined hepatic segmental resection, portal vein thrombectomy, portal vein repairment, hepatic hydatid internal capsule removal and external subtotal resection, cholecystectomy”. OUTCOMES: During follow-up after discharge, the patient did not regularly review and get further treatment and died 8 months after operation. LESSONS: May improve the clinicians’ understanding of CE complicated with HCC, and reduce the misdiagnosis of similar case, as well as provide guidance for clinical treatment.