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A 49-year-old man was admitted to our hospital with bloody sputum and chest pain. Computed tomography revealed bilateral multiple nodules, including a 54 × 43 mm cavity lesion in the left lung, a 119 × 87 mm mass with calcification in the posterior segment of the liver, and a right adrenal mass. Bronchoscopy was performed, but no diagnosis was made. Thoracoscopic left S5 partial lung resection was conducted for definitive diagnosis. The pathological diagnosis was echinococcosis. The patient was diagnosed with hepatic echinococcosis, bilateral multiple lung metastases, and right adrenal metastases. The liver and right adrenal mass were considered resectable. Lung resection preceded because the patient had respiratory symptoms. Partial resection was performed in two stages for multiple nodules in the right and left lungs. Posterior segmentectomy, partial S2 liver resection, cholecystectomy, and right adrenalectomy were performed later. All pathological findings indicated echinococcosis. Albendazole was administered after the diagnosis was confirmed, and its administration is still ongoing. A total of 12 years and 3 months have passed since the surgery, and no increase in residual lung lesions has been observed.

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