Abstract:

A 67-year-old male farmer of Han ethnicity from Gansu presented to the First Affiliated Hospital of Xinjiang Medical University on May 12, 2023, with a complaint of a mass on the right chest wall that had been present for over two months. He had a historical diagnosis of hepatic echinococcosis more than 30 years ago and had undergone a right lower lung lobectomy and right upper lung wedge resection for pulmonary echinococcosis in December 2021. His medical history also included close contact with livestock and dogs. Upon admission, a physical examination revealed a soft, mass approximately 30 cm × 20 cm in size in the vicinity of the axillary region of the right upper chest. The mass was firm, with clear boundaries and positive tenderness. Blood tests showed elevated eosinophil counts. Laboratory serology revealed positive IgG antibodies for Echinococcus and Toxoplasma. Enhanced abdominal CT and abdominal ultrasound identified multiple cystic lesions in the liver, left upper abdominal cavity, perisplenic area, right abdominal cavity, and chest wall. Notably, the lesion beneath the right chest wall extended into the subcutaneous tissue through the intercostal space, with areas of partial calcification. The patient was diagnosed with “multiple intraperitoneal echinococcosis with chest wall involvement”. Later, the patient underwent surgical removal of the cysts. Postoperative histological examination with HE staining showed homogeneous red staining in some regions of the lesion, along with scattered echinococcal structures and partial calcification. Postoperatively, the patient exhibited satisfactory recovery and was discharged in improved condition on June 13. Upon discharge, he was prescribed oral albendazole tablets at a dose of 10-15 mg/(kg•d), administered in divided doses after breakfast and dinner, continuing for six months. At the three-month follow-up, the patient reported no specific discomfort, and enhanced abdominal and pelvic CT scans indicated postoperative changes without significant abnormalities.

Key words: Hepatic echinococcosis, Peritoneal echinococcosis, Chest wall echinococcosis