title: [Cystic echinococcosis and hepatocellular carcinoma--a coincidence? A case report].
abstract: BACKGROUND
  The coincidence of echinococcosis and hepatocellular carcinoma (HCC) is quite rare. We report the case of a 45-year-old man who was admitted to our hospital because of abdominal pain in the right upper quadrant and jaundice. Clinical features and diagnostics: There was no history of weight loss or fever. No abdominal mass was palpable. The laboratory reports showed increased transaminase levels. Ultrasonography revealed an inhomogenous, cystic lesion measuring 6 cm in diameter in the segments VI and VII. Serology for echinococcosis was negative, alpha-fetoprotein (AFP) was considerably increased. CT scan showed a solid mass of 3,7 cm in diameter adjacent to the cystic lesion.
  
  
  RESULTS
  Anthelminthic therapy with albendazole caused a massive increase of cholestasis parameters and treatment had to be stopped. The simultaneous occurrence of serologically negative cystic echinococcosis and HCC was suspected and partial liver resection was performed. Histological examination confirmed both diagnoses and tumor resection in healthy tissue. 5 months after resection CT scan showed multicentric HCC affecting the whole liver. Palliative therapy with sorafenib was established.
  
  
  CONCLUSIONS
  The coincidence of HCC and cystic echinococcosis in the non-cirrhotic liver of a young man is a rare event. Despite resection in healthy tissue multicentric HCC was diagnosed 5 months later. Only few cases of simultaneous occurrence of HCC and echinococcosis have been published so far. Some authors considered echinococcosis as a trigger for HCC. A causal link between both entities has not been demonstrated until now.
authors.affiliation: Innere Medizin V, Klinikum Wels-Grieskirchen, Grieskirchen.
authors.forename: M
authors.initials: M
authors.lastname: Kübeck
authors.affiliation: Innere Medizin V, Klinikum Wels-Grieskirchen, Grieskirchen.
authors.forename: V
authors.initials: V
authors.lastname: Stöckl
authors.affiliation: Innere Medizin V, Klinikum Wels-Grieskirchen, Grieskirchen.
authors.forename: W
authors.initials: W
authors.lastname: Stainer
authors.affiliation: Abteilung für Chirurgie II, Klinikum Wels-Grieskirchen, Wels.
authors.forename: T
authors.initials: T
authors.lastname: Schermaier
authors.affiliation: Abteilung für Chirurgie II, Klinikum Wels-Grieskirchen, Wels.
authors.forename: J
authors.initials: J
authors.lastname: Preisinger
authors.affiliation: Abteilung für Chirurgie II, Klinikum Wels-Grieskirchen, Wels.
authors.forename: W
authors.initials: W
authors.lastname: Schauer
authors.affiliation: Institut für Pathologie, Klinikum Wels-Grieskirchen, Wels.
authors.forename: U
authors.initials: U
authors.lastname: Hochleitner
authors.affiliation: Institut für Pathologie, Klinikum Wels-Grieskirchen, Wels.
authors.forename: W
authors.initials: W
authors.lastname: Höbling
authors.affiliation: Institut für Pathologie, Universitätsklinikum Ulm.
authors.forename: T F E
authors.initials: TF
authors.lastname: Barth
authors.affiliation: Innere Medizin I, Klinikum Wels-Grieskirchen, Wels.
authors.forename: B
authors.initials: B
authors.lastname: Stadler
authors.affiliation: Innere Medizin I, Klinikum Wels-Grieskirchen, Wels.
authors.forename: P
authors.initials: P
authors.lastname: Knoflach
authors.affiliation: Innere Medizin V, Klinikum Wels-Grieskirchen, Grieskirchen.
authors.forename: A
authors.initials: A
authors.lastname: Kirchgatterer
mesh_terms: D003560:Cysts / Q000473:pathology* / Q000601:surgery; D003937:Diagnosis, Differential; D004444:Echinococcosis, Hepatic / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011230:Precancerous Conditions / Q000473:pathology* / Q000601:surgery; D016896:Treatment Outcome