Occult Cerebral Alveolar Echinococcosis with Liver and Lung Infection: A Case Report and the Literatures Review_West China Medical Journal

Authors：

 WuXintong ¹ , HeYongqiao ² , DengYongyi ²

1. Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Department of Neurology, People's Hospital of Ganzi Tibetan Autonomous Region, Ganzi, Sichuan 626000, P. R. China;

Corresponding?author：

Keywords：

Echinococcosis infection; Alveolar echinococcosis; Intracranial infection; Parasite

DOI：

10.7507/1002-0179.20160061

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Objective To summarize the clinical features of an adult patient with occult cerebral alveolar echinococcosis with liver and lung infection. Methods A Tibetan male patient in his middle age from the epidemic area of echinococcosis infection was diagnosed to have liver, lung and cerebral alveolar echinococcosis infection in Ganzi People's Hospital. He had the resection surgery, and the pathological result confirmed the primary diagnosis. We searched the literatures from January 1985 to December 2015 for occult cerebral alveolar echinococcosis and reviewed all the full texts in China Journal Full-text Database. Seventeen articles were qualified and 42 patients were reported. Combining with the relevant English literature using Medline, we analyzed the epidemic, pathophysiological and clinical manifestations of cerebral alveolar echinococcosis infection and explored the methods of prevention and treatment. Results According to the results of literature analysis, cerebral alveolar echinococcosis appeared often secondary to infection of other organs. Nervous system symptom concealed or progressed slowly; imaging and pathological tests were important for diagnosis. Resection surgery was the essential method of cure. Conclusion Alveolar echinococcosis can affect multiple organs. In patients without neurological symptoms, if other organs are found to be infected, it is important to screen patients with intracranial involvement. Because this kind of patients with intracranial lesions with hydatid are often secondary to other organ infection, active treatment in early phase is necessary in order to avoid further expansion of lesions and metastasis.

Citation： WuXintong, HeYongqiao, DengYongyi. Occult Cerebral Alveolar Echinococcosis with Liver and Lung Infection: A Case Report and the Literatures Review. West China Medical Journal, 2016, 31(2): 220-224. doi: 10.7507/1002-0179.20160061 Copy

1.	Garcia LS, Bruckner DA. Diagnostic medical parasitology[M]. 4th ed. Washington, DC:ASM Press, 2001:387-403.
2.	Tunaci M, Tunaci A, Engin G, et al. MRI of cerebral alveolar echinococcosis[J]. Neuroradiology, 1999, 41(11):844-846.
3.	Ammann RW, Eckert J. Cestode. Echinococcus[J]. Gastroenterol Clin North Am, 1996, 25(3):655-689.
4.	Aydin MD, Ozkan U, Altin?rs N. Quadruplets hydatid cysts in brain ventricles:a case report[J]. Clin Neurol Neurosurg, 2002, 104(4):300-302.
5.	Er?ahin Y, Mutluer S, Güzelba? E. Intracranial hydatid cysts in children[J]. Neurosurgery, 1993, 33(2):219-224.
6.	Jiménez-Mejías ME, Castillo-Ojeda E, Cuello Contreras JA, et al. Cerebral hydatidosis. Analysis of a series of 23 cases[J]. Med Clin (Barc) 1991, 97(4):125-132.
7.	Sadjjadi SM. Present situation of echinococcosis in the Middle East and Arabic North Africa[J]. Parasitol Int, 2006, 55 (Suppl):S197-S202.
8.	Prasad RS, Singh K, Sharma V. Primary intracranial hydatid cysts:review of ten cases[J]. World J Surg Res, 2013, 4:12-18.
9.	Bükte Y, Kemaloglu S, Nazaroglu H, et al. Cerebral hydatid disease:CT and Mr imaging findings[J]. Swiss Med Wkly, 2004, 134(31/32):459-467.
10.	Evliyaoglu C, Keskil S. Possible spontaneous "birth" of a hydatid cyst into the lateral ventricle[J]. Childs Nerv Syst, 2005, 21(5):425-428.
11.	Iyigun O, Uysal S, Sancak R, et al. Multiple organ involvement hydatid cysts in a 2-year-old boy[J]. J Trop Pediatr, 2004, 50(6):374-376.
12.	Kamath SM, Mysorekar VV, Rao SG, et al. Intraventricular hydatid cyst in a child[J]. Indian J Pathol Microbiol, 2009, 52(4):571-572.
13.	Maurya P, Singh VP, Prasad R, et al. Intraventricular hydatid cyst causing entrapped temporal horn syndrome:a case report and review of literature[J]. J Pediatr Neurosci, 2007, 2:20-22.
14.	Stojkovic M, Junghanss T. Cystic and alveolar echinococcosis[J]. Handb Clin Neurol, 1994, 114:51-52.
15.	馬娟, 王儉. 磁共振多技術成像對腦泡型包蟲病及其邊緣帶的研究進展[J]. 新疆醫科大學學報, 2015(4):514-516.
16.	Boles DM. Cerebral echinococciasis[J]. Surg Neurol, 1981, 16(4):280-282.
17.	Guzel A, Tatli M, Maciaczyk J, et al. Primary cerebral intraventricular hydatid cyst:a case report and review of the literature[J]. J Child Neurol, 2008, 23(5):585-588.
18.	Kak VK, Mathuriya SN. Hydatid disease of the nervous system[M]//Chopra JS, Sawhney BI. Neurology in tropics. London:Churchill Livingstone, 1999:244-258.
19.	King C. Cestodes(tapeworms)[M]//Mandell G, Bennett J, Dolin R. Principles and practices of infectious diseases. 5th ed. New York:Churchill Livingstone, 2000:633-640.
20.	Krajewski R, Stelmasiak Z. Cerebral hydatid cysts in children[J]. Childs Nerv Syst, 1991, 7(3):154-155.
21.	Sharma SC, Ray RC. Primary hydatid cyst of the brain in an adult:report of a case[J]. Neurosurgery, 1988, 23(3):374-376.
22.	Diren HB, Ozcanli H, Boluk M, et al. Unilocular orbital, cerebral and intraventricular hydatid cysts:CT diagnosis[J]. Neuroradiology, 1993, 35(2):149-150.
23.	Rivierez M, El-Azhari A, El Tantaoui M, et al. Hydatid cyst of the cavernous sinus. A case[J]. Neurochirurgie, 1992, 38(1):46-49.
24.	Haliloglu M, Saatci I, Akhan O, et al. Spectrum of imaging findings in pediatric hydatid disease[J]. AJR Am J Roentgenol, 1997, 169(6):1627-1631.
25.	Pasaoglu A, Orhon C, Akdemir H. Multiple primary hydatid cysts of the brain[J]. Turkish J Pediatrics, 1989, 31(1):57-61.
26.	Sierra J, Oviedo J, Berthier M, et al. Growth rate of secondary hydatid cysts of the brain. Case report[J]. J Neurosurg, 1985, 62(5):781-782.
27.	Abbassioun K, Amirjamshidi A. Diagnosis and management of hydatid cyst of the central nervous system:Part 1:general considerations and hydatid disease of the brain[J]. Neurosurg Q, 2001, 11:1-9.
28.	Siles-Lucas MM, Gottstein BB. Molecular tools for the diagnosis of cystic and alveolar echinococcosis[J]. Trop Med Int Health, 2001, 6(6):463-475.
29.	Polat P, Kantarci M, Alper F, et al. Hydatid disease from head to toe[J]. Radiographics, 2003, 23(2):475-494.
30.	Kohli A, Gupta RK, Poptani H, et al. In vivo proton magnetic resonance spectroscopy in a case of intracranial hydatid cyst[J]. Neurology, 1995, 45(3 Pt 1):562-564.
31.	Pandey S, Pandey D, Shende N, et al. Cerebral intraventricular echinococcosis in an adult[J]. Surg Neurol Int, 2015, 6:138.
32.	Okur A, Ogul H, Sengul G, et al. Magnetic resonance spectroscopy and magnetic resonance imaging findings of the intracerebral alveolar echinococcosis[J]. J Craniofac Surg, 2014, 25(4):1352-1353.
33.	Dharker SR. Hydatid disease[M]//Ramamurthi B, Tandon PN. Text book of neurosurgery. 2th ed. New Delhi:Churchill Livingstone, 1996:535-544.
34.	Brunetti E, Kern P, Vuitton DA. Writing Panel for the WHO-IWGE (2010). Expert consensus for the diagnosis and treatment of cystic and alveolar echinococcosis in humans[J]. Acta Trop, 2010, 114(1):1-16.
35.	Altin?rs N, Bavbek M, Caner HH, et al. Central nervous system hydatidosis in Turkey:a cooperative study and literature survey analysis of 458 cases[J]. J Neurosurg, 2000, 93(1):1-8.

1. Garcia LS, Bruckner DA. Diagnostic medical parasitology[M]. 4th ed. Washington, DC:ASM Press, 2001:387-403.
2. Tunaci M, Tunaci A, Engin G, et al. MRI of cerebral alveolar echinococcosis[J]. Neuroradiology, 1999, 41(11):844-846.
3. Ammann RW, Eckert J. Cestode. Echinococcus[J]. Gastroenterol Clin North Am, 1996, 25(3):655-689.
4. Aydin MD, Ozkan U, Altin?rs N. Quadruplets hydatid cysts in brain ventricles:a case report[J]. Clin Neurol Neurosurg, 2002, 104(4):300-302.
5. Er?ahin Y, Mutluer S, Güzelba? E. Intracranial hydatid cysts in children[J]. Neurosurgery, 1993, 33(2):219-224.
6. Jiménez-Mejías ME, Castillo-Ojeda E, Cuello Contreras JA, et al. Cerebral hydatidosis. Analysis of a series of 23 cases[J]. Med Clin (Barc) 1991, 97(4):125-132.
7. Sadjjadi SM. Present situation of echinococcosis in the Middle East and Arabic North Africa[J]. Parasitol Int, 2006, 55 (Suppl):S197-S202.
8. Prasad RS, Singh K, Sharma V. Primary intracranial hydatid cysts:review of ten cases[J]. World J Surg Res, 2013, 4:12-18.
9. Bükte Y, Kemaloglu S, Nazaroglu H, et al. Cerebral hydatid disease:CT and Mr imaging findings[J]. Swiss Med Wkly, 2004, 134(31/32):459-467.
10. Evliyaoglu C, Keskil S. Possible spontaneous "birth" of a hydatid cyst into the lateral ventricle[J]. Childs Nerv Syst, 2005, 21(5):425-428.
11. Iyigun O, Uysal S, Sancak R, et al. Multiple organ involvement hydatid cysts in a 2-year-old boy[J]. J Trop Pediatr, 2004, 50(6):374-376.
12. Kamath SM, Mysorekar VV, Rao SG, et al. Intraventricular hydatid cyst in a child[J]. Indian J Pathol Microbiol, 2009, 52(4):571-572.
13. Maurya P, Singh VP, Prasad R, et al. Intraventricular hydatid cyst causing entrapped temporal horn syndrome:a case report and review of literature[J]. J Pediatr Neurosci, 2007, 2:20-22.
14. Stojkovic M, Junghanss T. Cystic and alveolar echinococcosis[J]. Handb Clin Neurol, 1994, 114:51-52.
15. 馬娟, 王儉. 磁共振多技術成像對腦泡型包蟲病及其邊緣帶的研究進展[J]. 新疆醫科大學學報, 2015(4):514-516.
16. Boles DM. Cerebral echinococciasis[J]. Surg Neurol, 1981, 16(4):280-282.
17. Guzel A, Tatli M, Maciaczyk J, et al. Primary cerebral intraventricular hydatid cyst:a case report and review of the literature[J]. J Child Neurol, 2008, 23(5):585-588.
18. Kak VK, Mathuriya SN. Hydatid disease of the nervous system[M]//Chopra JS, Sawhney BI. Neurology in tropics. London:Churchill Livingstone, 1999:244-258.
19. King C. Cestodes(tapeworms)[M]//Mandell G, Bennett J, Dolin R. Principles and practices of infectious diseases. 5th ed. New York:Churchill Livingstone, 2000:633-640.
20. Krajewski R, Stelmasiak Z. Cerebral hydatid cysts in children[J]. Childs Nerv Syst, 1991, 7(3):154-155.
21. Sharma SC, Ray RC. Primary hydatid cyst of the brain in an adult:report of a case[J]. Neurosurgery, 1988, 23(3):374-376.
22. Diren HB, Ozcanli H, Boluk M, et al. Unilocular orbital, cerebral and intraventricular hydatid cysts:CT diagnosis[J]. Neuroradiology, 1993, 35(2):149-150.
23. Rivierez M, El-Azhari A, El Tantaoui M, et al. Hydatid cyst of the cavernous sinus. A case[J]. Neurochirurgie, 1992, 38(1):46-49.
24. Haliloglu M, Saatci I, Akhan O, et al. Spectrum of imaging findings in pediatric hydatid disease[J]. AJR Am J Roentgenol, 1997, 169(6):1627-1631.
25. Pasaoglu A, Orhon C, Akdemir H. Multiple primary hydatid cysts of the brain[J]. Turkish J Pediatrics, 1989, 31(1):57-61.
26. Sierra J, Oviedo J, Berthier M, et al. Growth rate of secondary hydatid cysts of the brain. Case report[J]. J Neurosurg, 1985, 62(5):781-782.
27. Abbassioun K, Amirjamshidi A. Diagnosis and management of hydatid cyst of the central nervous system:Part 1:general considerations and hydatid disease of the brain[J]. Neurosurg Q, 2001, 11:1-9.
28. Siles-Lucas MM, Gottstein BB. Molecular tools for the diagnosis of cystic and alveolar echinococcosis[J]. Trop Med Int Health, 2001, 6(6):463-475.
29. Polat P, Kantarci M, Alper F, et al. Hydatid disease from head to toe[J]. Radiographics, 2003, 23(2):475-494.
30. Kohli A, Gupta RK, Poptani H, et al. In vivo proton magnetic resonance spectroscopy in a case of intracranial hydatid cyst[J]. Neurology, 1995, 45(3 Pt 1):562-564.
31. Pandey S, Pandey D, Shende N, et al. Cerebral intraventricular echinococcosis in an adult[J]. Surg Neurol Int, 2015, 6:138.
32. Okur A, Ogul H, Sengul G, et al. Magnetic resonance spectroscopy and magnetic resonance imaging findings of the intracerebral alveolar echinococcosis[J]. J Craniofac Surg, 2014, 25(4):1352-1353.
33. Dharker SR. Hydatid disease[M]//Ramamurthi B, Tandon PN. Text book of neurosurgery. 2th ed. New Delhi:Churchill Livingstone, 1996:535-544.
34. Brunetti E, Kern P, Vuitton DA. Writing Panel for the WHO-IWGE (2010). Expert consensus for the diagnosis and treatment of cystic and alveolar echinococcosis in humans[J]. Acta Trop, 2010, 114(1):1-16.
35. Altin?rs N, Bavbek M, Caner HH, et al. Central nervous system hydatidosis in Turkey:a cooperative study and literature survey analysis of 458 cases[J]. J Neurosurg, 2000, 93(1):1-8.

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Occult Cerebral Alveolar Echinococcosis with Liver and Lung Infection: A Case Report and the Literatures Review

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