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Pancreatic echinococcosis.
Priti Soin1, Pranav Sharma2, Puneet Singh Kochar2
1Department of Pathology, GLM HospitalDelhiIndia.
Proceedings (Baylor University. Medical Center)
|April 23, 2019
Summary
Pancreatic echinococcosis, a rare parasitic infection, was diagnosed in a woman presenting with abdominal pain. Imaging revealed a cystic mass, confirmed by endoscopic ultrasound showing the water lily sign.
Area of Science:
- Gastroenterology and Parasitology
- Medical Imaging
- Diagnostic Medicine
Background:
- Echinococcosis, caused by *Echinococcus granulosus* larvae, typically affects the liver and lungs.
- Pancreatic involvement is exceptionally rare, accounting for only 0.14% to 0.2% of cases, even in endemic regions.
Observation:
- A 34-year-old woman presented with a month of epigastric pain.
- Contrast-enhanced CT revealed a 4.0-cm hypodense mass in the pancreatic head and uncinate process.
- MRI showed a nonenhancing cystic mass, while endoscopic ultrasound displayed a cystic structure with curvilinear membranes, characteristic of the water lily sign.
Findings:
- The endoscopic ultrasound findings were pathognomonic for hydatid disease.
- Enzyme-linked immunosorbent assay (ELISA) for echinococcal antigen was positive, confirming the diagnosis.
Implications:
- This case highlights the importance of considering rare diagnoses like pancreatic echinococcosis in patients with pancreatic cystic lesions.
- Accurate and timely diagnosis through advanced imaging and serological tests is crucial for effective management of this rare condition.
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