Combination of Liver and brain hydatidosis: A rare presentation

Contributed  by

Dr Syed Aalishan Fatima  &  Prof. Majid Jahangir

Dept. of Radiodiagnosis

Govt Medical College Srinagar ,Kashmir 

Clinical scenario:

A 60 year old female patients presented  with history of pain abdomen ,breathlessness ,

headache .She also complained of  vomiting for 2day duration

With these symptoms she  was admitted to  emergency ward of our hospital.

O/E she was conscious , oriented and her vitals were stable

The neck was free and there were no meningeal signs

Initial NCCT  showed a calcified mass in the left frontoparietal with profound oedema .

Later  MRI brain was done which showed the lesion was isointense to cerebral white matter   on T1-weighted images.

T2- weighed images revealed a heterogeneous low-intensity mass with peripheral high signal intensity consistent with oedema , blooming  and peripheral ring enhancement on post contrast study

Contrast enhanced CT scan abdomen  showed  a non enhancing infiltrating hepatic solid mass that contains multiple cystic-necrotic hypodense areas and hyperattenuating foci of internal calcifications .

Infiltration into hepatic veins and intrahepatic IVC  was also  noted.

Fig CT scan abdomen showing liver mass

Teaching message :

It is known that human parasitic zoonoses sometimes cause diagnostic and therapeutic problems. Radiologic imaging findings may contribute to the diagnosis of alveolar hydatid disease. AE lesions may be misdiagnosed as malignancies, and it is important for radiologists to have good command of typical imaging features of AE and to provide early diagnosis for patients from high prevalence areas, thereby guiding clinicians in the correct direction.

Further reading 

Hydatid disease of the brain and spine