Primary combined lobar/diaphragm resection and liver transplantation for locally advanced alveolar echinococcosis: Report of a challenging case - 12/03/22
, Hannah Van Malenstein a , Jacques Pirenne b , Diethard Monbaliu b , Vincent Vandecaveye c , Paul De Leyn d , Chris Verslype a
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Highlights |
• | Alveolar echinococcosis (AE) is considered the most pathogenic zoonosis in humans in the northern hemisphere. |
• | Because of the slow, tumor-like growth of the parasite, patients usually present late, when radical resection is no longer possible. |
• | In end-stage AE, liver transplantation represents an option as palliative treatment. |
• | With all current advances in surgical techniques, medical treatment and follow-up methods, prognosis after transplantation has significantly improved. |
• | Recurrence remains a possibility, but resurgence of the parasite is expected to be slow, and surgical interventions remain a possibility. |
Abstract |
In alveolar echinococcosis (AE) radical surgery is still the only curative option. Because of the slow, tumor-like growth with invasion into surrounding tissue, patients usually present late when radical resection with preservation of sufficient functional liver tissue is no longer possible. In end-stage AE, liver transplantation represents an option as palliative treatment for life-threatening complications. We present a case of AE complicated by hepato-pulmonary fistula treated curatively with liver transplantation combined with resection of the right and central diaphragm, part of the pericardium and the inferior right lung. Only few cases with end-stage AE have been treated so far by such extensive surgery. Five years after surgery, PET/CT and MRI imaging are suggestive of limited local recurrence, for which the patient is still treated with albendazole and monitored closely.
Le texte complet de cet article est disponible en PDF.Keywords : Alveolar echinococcosis, Echinococcus multilocularis, Liver transplantation, Diaphragm resection, Lobar resection, Case report
Plan
Vol 6
Article 100058- avril 2022 Retour au numéro
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