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Background  Cystic echinococcosis is a zoonotic infection caused by  Echinococcus granulosus . This case report shows the difficulty in differential diagnosis in a patient with highly suspected hydatid disease.    Case presentation  A 29-year-old Chinese woman presented with progressive abdominal distension. Imaging results revealed a large multicystic tumor with typical features of hydatid disease. There was no clear relationship between the cystic tumor and the liver, which led to the assumption of primary extrahepatic cystic echinococcosis. After albendazole therapy was initiated, a laparotomy was performed and a huge ovarian cystadenoma was diagnosed.    Conclusions  This case highlights the possible challenges of differential diagnosis in patients with suspicion of hydatid cysts.

A young woman from an Echinococcus-endemic area with progressive abdominal distension: a case report