A tumor-mimicking parasitic disease: Radiological Findings of Alveolar Echinococcosis

Abstract

Background: Alveolar echinococcosis(AE) is a tumor-mimicking parasitic disease caused by Echinococcus multilocularis. We have aimed to present the radiological imaging findings of AE characterized by malignant features.
Methods: The radiological findings of 20 patients were evaluated retrospectively; who were admitted to our hospital in the Van province in the years between 2014 and 2020 and who were diagnosed with AE. Of these patients, 30% had been operated due to a preliminary diagnosis of a tumor. The study was conducted retrospectively by examining the drawback radiological images of patients from the radiological data archiving system. The diagnosis of AE was confirmed when lesions manifested the following radiological imaging findings: irregular margins, no contrast uptake in dynamic contrast images or late peripheral enhancement, presence of calcifications, and contralateral lobe hypertrophy.
Results: The mean age of the patients at the time of diagnosis was 50.95 (12-86) years. Of the patients, 15 (75%) were women and 5 (25%) were men. Typical histopathological and radiological imaging findings were present in 8 (40%) and 17 (85%) patients, respectively. Only 12 (60%) out of 20 patients had seropositivity by ELISA. The remaining 8 (40%) patients were seronegative.
Conclusion: Radiological imaging examinations are essential in the diagnosis and the evaluation of the extent of the disease. Different radiological technic can be used to differentiate AE from other diseases. Early diagnosis is important for avoiding unnecessary or inadequate operations due to a misdiagnosis and for preventing potential complications.

Keywords: Alveolar echinococcosis, Tumor like lesion, Ultrasonography, Computed Tomography, Magnetic Resonance Imaging