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A case of alveolar echinococcosis in the liver that ruptured into the pericardium treated by a combination of hepatectomy and albendazole

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Title: A case of alveolar echinococcosis in the liver that ruptured into the pericardium treated by a combination of hepatectomy and albendazole
Authors: Yamamoto, Yoichi Browse this author
Sakamoto, Yuzuru Browse this author →KAKEN DB
Kamiyama, Toshiya Browse this author →KAKEN DB
Nagatsu, Akihisa Browse this author
Asahi, Yoh Browse this author
Orimo, Tatsuya Browse this author →KAKEN DB
Kakisaka, Tatsuhiko Browse this author →KAKEN DB
Kamachi, Hirofumi Browse this author →KAKEN DB
Otsuka, Takuya Browse this author
Mitsuhashi, Tomoko Browse this author
Taketomi, Akinobu Browse this author →KAKEN DB
Keywords: Alveolar echinococcus
Issue Date: 8-Apr-2022
Publisher: Springer
Journal Title: Surgical case reports
Volume: 8
Issue: 1
Start Page: 63
Publisher DOI: 10.1186/s40792-022-01417-6
Abstract: Background Alveolar echinococcosis (AE) is a rare parasitic disease caused by the larva of Echinococcus multilocularis. It nearly always occurs in the liver, and cardiac involvement is extremely rare. Liver resection is the most effective intervention for AE because the only potentially curative treatment is removal of the lesion. Even when complete resection is not performed, long-term survival can be expected after surgical removal of most of the lesion with lifelong administration of albendazole (ABZ). Case presentation A 64-year-old man who lived in Hokkaido was referred to our hospital due to abnormalities in biliary enzymes. According to the findings from enhanced computed tomography and magnetic resource imaging of the abdomen, transthoracic echocardiography and serologic tests, he was diagnosed with hepatic AE with rupture into the pericardium. He underwent extended left hemi-hepatectomy with reconstruction of the inferior vena cava and opening of the pericardium with drainage as reduction surgery. Pathological examination revealed echinococcal infection in the pericardium as well as the liver. He started chemotherapy with 400 mg ABZ per Day 67 days after surgery. Although the surgical margin was positive in the pathological findings, he was alive 19 months later with no regrowth of the echinococcal lesion. Conclusion AE with cardiac involvement is extremely rare. Even if the complete removal of cardiac-involved AE is not possible, surgical debulking with lifelong ABZ treatment can successfully manage the disease.
Type: article
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

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