Échinococcose alvéolaire hépatique : à propos d'un cas

Thirty-five years old men who have lived in the East of France until the age of 10 consults for non-febrile jaundice obstructive syndrome evolving for 3 days. Clinical examination is normal. Abdominal ultrasound reveals a large, irregular and heterogeneous left liver mass, corresponding in precontrast CT with a hypodense mass infiltrative with central calcification. There is not any contrast enhancement in post contrast CT but note a mild biliary duct dilatation and thrombosis of the portal vein. MRI objectives a T1 hypointensity and T2 hyperintensity multiple vesicular structure and necrotic area, which compressed biliary ducts and the portal vein. F18-FDG PET scan demonstrated an inflammatory peri-lesional fixation. There is no extrahepatic focus. An ultrasound-guided hepatic biopsy shows lamelar fibro-hyaline fragments with dystrophic calcifications suggestive of alveolar echinococcosis. An enlarged left hepatectomy confirms alveolar hepatic echinococcosis. Alveolar echinococcosis of the liver is rare. The lesion simulates tumor but the MRI facilitate the diagnosis and shows more the extension of the lesion.