Showing papers on "Alveolar hydatid disease published in 1997"

Cytologic diagnosis of isolated pancreatic alveolar hydatid disease with immunologic and PCR analyses : A case report

Abstract: BACKGROUND Alveolar hydatid disease (AHD) is a rare and severe parasitic infection caused by the larval stage of the fox tapeworm, Echinococcus multilocularis. AHD mainly involves the liver, and although it may extend progressively to the pancreas, isolated pancreatic localization has not been reported previously. CASE A 68-year-old white female presented with a multicystic mass in the pancreas. Fine needle aspiration showed some protoscolices, free hooklets and fragments of laminated layer, which are pathognomonic features of echinococcosis. Serologic analyses by an enzyme-linked immunosorbent assay using Em2plus antigen showed high antibody reactivity of the patient's serum, which is indicative of an infection with E multilocularis. Diagnosis was finally confirmed by molecular and immunologic analyses of the cytologic material by polymerase chain reaction and direct immunofluorescence. CONCLUSION This case illustrates the value of cytology in the identification of echinococcosis, particularly when it involves extrahepatic sites, where the risk of misdiagnosis may be related to its extremely rare occurrence. Precise parasitologic tying of E multilocularis in endemic areas is important.

Surgical Treatment of Advanced Alveolar Hydatid Disease of the Liver: A Report of Five Cases

Abstract: We report herein the cases of five patients with alveolar hydatid disease (AHD) of the liver who were diagnosed and underwent surgery at the Department of Surgery of Ankara University between 1989 and 1994. In all five patients, the final diagnosis was established by frozen section of the lesion during laparotomy. Lesions of AHD were found only in the liver. Hepatic resections including right lobectomy and segmentectomy were performed in three patients while palliative procedures were carried out in the remaining two patients with unresectable disease. There was no operative mortality, and only one late death occurred 3 years after the hepatic resection. In this paper, we present the clinical and operative findings of these five patients and their outcomes, followed by a review of the surgical treatment of AHD.

Liver Transplantation in Alveolar Hydatid Disease

Abstract: Alveolar echinococcosis (AE), or alveolar hydatid disease (AHD), is an uncommon parasitic disease which behaves like a malignant tumor of the liver, producing liver necrosis and invading the biliary tract, main hepatic vessels and surrounding structures. Only 25% of the patients are candidates for radical surgical resection, the only currently available definitive treatment. Ortho-topic liver transplantation (OLT) has been performed for terminal AE since the mid-1980s. This article reviews the specific problems related to OLT in AE. They represent a number of relative contraindications. Invasion of the duodenum and pancreas or the right atrium by the parasitic masses, and cerebral metastases, are absolute contraindication to OLT. Today, OLT can be considered in AE patients with chronic Budd-Chiari syndrome, severe secondary biliary cirrhosis, intractable cholangitis and biliary sepsis, or involvement of both lobes where radical resection is not possible. In our series, which comprises 22 of the 28 European patients transplanted for AE, 1- and 5-year actuarial survival are 78 and 65% respectively.