International Journal of Clinical & Medical Images

An 83 year old female with a history of echinococcal cyst diagnosed in 2006 in Bangladesh presented with abdominal pain. MRI/MRCP revealed a large hepatic cyst with multiple internal septations comprising most of segments 7 and 8 of the liver measuring 9.3 x 9.5 x 8.8 cm in AP by transverse by craniocaudal dimension. An additional hepatic cyst with internal heterogeneous material and septations within segments 2 and 3 of the liver and extending inferiorly to the mid abdomen at the level of the iliac bifurcation measuring 13.0 x 15.8 x 18.3 cm in in the transverse by craniocaudal dimension was identified (Figure). The findings were consistent with hydatid disease. The patient was treated with albendazole. Because the lesions were deemed not amenable to PAIR (puncture, aspiration, injection and re-aspiration), the patient was subsequently taken to the operating room for surgical enucleation of the lesions.

Corresponding authors
Gaya Spolverato and Timothy M. Pawlik
Johns Hopkins Hospital
Baltimore
USA