Mucinous cystic neoplasm of the liver: mimicker of echinococcal cyst

Abstract

Mucinous cystic neoplasm of the liver (MCN) is uncommon and sometimes misdiagnosed as Echinococcal cyst, especially when patient with history of echinococcus infection. We report an asymptomatic 60 year-old woman with history of echinococcal cyst in the liver which was resected approximately 20 years ago, developed a new liver cystic lesion approximately 7 years after resection. Contrast enhanced computed tomography demonstrated a 7.4 x 5.6 x 5.4 cm cystic lesion in the right hepatic lobe with thin septations and no enhancing solid components. Though the serum antibody to Echinococcus was negative, the diagnosis of Echinococcal cyst was made and the patient was started empirically on Echinococcal therapy based on her clinical history and imaging findings. Post treatment CT scan showed that the cyst continued to grow. A partial right lobectomy was performed and the final diagnosis was mucinous cystic neoplasm of the liver (MCN).

Mucinous Cystic Neoplasm of the Liver Masquerading as an Echinococcal Cyst: Radiologic-pathologic Differential of Complex Cystic Liver Lesions

“…[ 7 ] Serum echinococcal antibody and tumor markers can aid in the differentiation although sensitivity is not 100%. [ 8 ] Immunoblot and ELISA assays are also helpful in identifying echinococcal cysts. [ 6 ]…”