Cystic echinococcosis in immigrant from Peru: first case treated with percutaneous treatment in Japan.
We report a case of cystic echinococcosis (CE) caused by Echinococcusgranulosus, for which a modified percutaneous evacuation (PEVAC) treatment was applied. The patient had immigrated from Peru to Japan and had 2 hydatid cystic masses, 1 located in segment (S)5 of the liver and the other in S3 (5.3 and 3.5 cm in diameter, respectively), both of which were visualized as pseudotumors by ultrasound (US) examinations. Albendazole treatment showed no effects and surgical treatment was refused. After punctuation of the S5 cyst under US guidance and S3 with CT guidance, 10- and 12-French gauge catheters, respectively, with multiple side holes were inserted. About 60 ml of the cyst contents was drawn out from the S5 lesion and 2 ml from the S3 lesion. Using repetitive manual injections and aspiration of small amounts of hypertonic saline, the remaining cyst content was removed as much as possible, after which 20 and 10 ml of 98% ethanol was injected into the S5 and S3 lesions, respectively. A short-term evaluation during the 4 month-period following the procedure using US revealed nearly complete evacuation of the S5 lesion, whereas that at S3 remained as a pseudo-solid mass. We consider that percutaneous treatment is a safe therapeutic modality for hydatid cysts. This is the first case report of CE treated percutaneously in Japan.
Sakaguchi
Hiroshi
H
Department of Radiology, Nara Medical University, Kashihara 634-8521, Japan.
Tanaka
Toshihiro
T
Marugami
Nagaaki
N
Kichikawa
Kimihiko
K
Horiuchi
Hazuki
H
Morioka
Chie
C
Toyohara
Masahisa
M
Moriya
Kei
K
Nishiofuku
Mariko
M
Mitoro
Akira
A
Fukui
Hiroshi
H
Hirai
Toshiko
T
Yamashita
Namiko
N
Ouji
Yukiteru
Y
Ishizaka
Shigeaki
S
Yoshikawa
Masahide
M
D000818:Animals; D044963:Biopsy, Fine-Needle; D004444:Echinococcosis, Hepatic / Q000000981:diagnostic imaging* / Q000469:parasitology / Q000473:pathology / Q000628:therapy*; D048209:Echinococcus granulosus; D004641:Emigration and Immigration; D000431:Ethanol / Q000008:administration & dosage; D006801:Humans; D006982:Hypertonic Solutions / Q000008:administration & dosage; D007564:Japan; D010568:Peru; D011677:Punctures / Q000379:methods; D016896:Treatment Outcome; D014463:Ultrasonography
D006982:Hypertonic Solutions; D000431:Ethanol