title: Recurrent hepatic alveolar echinococcosis: report of the first case in Korea with unproven infection route.
abstract: Human alveolar echinococcosis (AE), a hepatic disorder that resembles liver cancer, is a highly aggressive and lethal zoonotic infection caused by the larval stage of the fox tapeworm, Echinococcus multilocularis. E. multilocularis is widely distributed in the northern hemisphere; the disease-endemic area stretches from north America through Europe to central and east Asia, including northern parts of Japan, but it has not been reported in Korea. Herein, we represent a first case of AE in Korea. A 41-year-old woman was found to have a large liver mass on routine medical examination. The excised mass showed multinodular, necrotic, and spongiform appearance with small irregular pseudocystic spaces. Microscopically, the mass was composed of chronic granulomatous inflammation with extensive coagulation necrosis and parasite-like structure, which was revealed as parasitic vesicles and laminated layer delineated by periodic acid-Schiff (PAS) stain. Clinical and histologic features were consistent with AE. After 8 years, a new liver mass and multiple metastatic pulmonary nodules were found and the recurred mass showed similar histologic features to the initial mass. She had never visited endemic areas of AE, and thus the exact infection route is unclear.
authors.affiliation: Department of Pathology, Dong-A University College of Medicine, Busan 602-714, Korea.
authors.forename: Su-Jin
authors.initials: SJ
authors.lastname: Kim
authors.forename: Jong-Han
authors.initials: JH
authors.lastname: Kim
authors.forename: Sang-Young
authors.initials: SY
authors.lastname: Han
authors.forename: Young-Hoon
authors.initials: YH
authors.lastname: Kim
authors.forename: Jin-Han
authors.initials: JH
authors.lastname: Cho
authors.forename: Jong-Yil
authors.initials: JY
authors.lastname: Chai
authors.forename: Jin-Sook
authors.initials: JS
authors.lastname: Jeong
mesh_terms: D000328:Adult; D015766:Albendazole / Q000627:therapeutic use*; D000818:Animals; D000871:Anthelmintics / Q000627:therapeutic use*; D004444:Echinococcosis, Hepatic / Q000175:diagnosis* / Q000188:drug therapy / Q000601:surgery; D004446:Echinococcus / Q000302:isolation & purification; D005260:Female; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology*; D011859:Radiography; D012008:Recurrence; D056910:Republic of Korea; D016896:Treatment Outcome; D015047:Zoonoses
chemical_list: D000871:Anthelmintics; D015766:Albendazole