Hidatidosis quística simulando una neoplasia hepática invasiva / Cystic hydatidosis simulating an invasive hepatic neoplasia

La hidatidosis/equinococosis quística es una infección zoonótica, endémica en muchos países de América del Sur, caracterizada por lesiones hepáticas que radiológicamente pueden simular neo-plasias malignas de aspecto quístico y que, dependiendo del tiempo de evolución y del grado de obstrucción de la vía biliar, pueden cursar con insuficiencia hepática, por lo cual es importante un diagnóstico oportuno. Presentamos el caso de un paciente masculino de 35 años, sin antecedentes patológicos de importancia, perteneciente a una comunidad indígena y residente de una zona rural de Colombia, quien presentó un cuadro clínico y pruebas de laboratorio sugestivos de obstrucción de la vía biliar, la cual fue confirmada con el hallazgo de una masa hepática quística infiltrante en los estudios imagenológicos, sospechándose inicialmente una etiología neoplásica maligna. El paciente finalmente falleció tras procedimiento quirúrgico, y su estudio histopatológico reveló una hidatidosis quística como diagnóstico definitivo.

Cystic echinococcosis/hydatidosis is a zoonotic infection, endemic in many South American coun-tries, characterized by liver lesions that radiologically can simulate malignant neoplasms with a cystic appearance, and depending on the time of progression and degree of obstruction of the bile duct, can present with liver failure, so a prompt diagnosis is important. We present the case of a 35-year-old male patient, with no significant pathological history, from an indigenous community and resident of a rural area in Colombia, who presented clinical symptoms and laboratory tests suggestive of bile duct obstruction, which was confirmed with the finding of an infiltrating cystic liver mass in imaging studies, initially suspecting a malignant neoplastic etiology. The patient developed a fulminant course after surgery, and the histopathological study revealed cystic hydatidosis as the definitive diagnosis.

Management of hepatic hydatidosis by laparoscopic approach in rural central India: a 3 year experience.

Background: Hydatid disease is still a major health problem in the infested areas of world, mainly in sheep-raising areas. But owing to increased travel and tourism all over the world, it can be found anywhere, even in developed countries.1 Thus, surgeons in nonendemic areas encounter the disease and should be aware of its optimum treatment. A safe, new method of laparoscopic management of hepatic hydatidosis is described along with the review of relevant literature. Methods: From April 2011 to October 2013, Fifteen cases of hepatic hydatid disease were operated on laparoscopically using the Palanivelu hydatid system. Results: The majority of the patients presented in the 4th decade (43.3%) with female sex predisposition (70% females). Most common presenting feature was pain the in upper abdomen. Most of the patients had only a single cyst (76.6%). The right lobe of the liver was most commonly involved. Cysts were bilateral in 6 patients. In all the patients simple evacuation of the hydatid cyst by the palanivelu hydatid system was done. The remnant cavity was dealt with by omentoplasty. The average follow-up period is 6 months. There have been no recurrences to date. Conclusions: Minimal invasive management, using Palanivelu hydatid system for aspiration and laparoscopic intervention, is an alternative to open surgery because of its ability to prevent spillage and thus minimize recurrences.