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FIGURE B: Surgical photographs. (1): The black arrows indicate hepatic alveolar echinococcosis lesions. (2): The white arrows indicate hepatic cystic echinococcosis lesions. Hematoxylin and eosin staining. (3): The black and white arrows indicate the lesion and inflammatory response zones, respectively (original magnification × 10). (4): The black and white arrows indicate the lesion and inflammatory response zones, respectively (original magnification ×100). A 40-year-old female visited our hospital with a chief complaint of pain in the right superior abdominal quadrant for the last 2 months. The serological tests were positive for Echinococcosis IgG antibodies. Contrast-enhanced computed tomography of the abdomen revealed multiple irregular lesions in the liver, with a maximum cross-sectional area of 17.4×10.8 cm2 involving mainly the right lobe and partiallysegments 3 and 4 (Figure A). The preoperative diagnosis was hepatic alveolar echinococcosis (P4,N1,M0) based on the typical imaging characteristics, serological test results, medical history, and contact history of the epidemic area, among other factors1.

Mixed infection with two types of echinococcosis misdiagnosed as hepatic alveolar echinococcosis