Alveolar echinococcosis of the liver in children

Abstract

Alveolar echinococcosis of the liver is uncommon in childhood. We have treated 124 patients with this disease in our hospital over the past 50 years; 7 of them were less than 15 years old (4.7%). Five were females and 2 were males. In adults, it takes more than 10 years after infestation for clinical symptoms to develop. Alveolar echinococcosis in children seems to progress more rapidly than in adults. Among the first 3 pediatric patients, 2 had hepatomegaly and the 3rd was detected due to liver dysfunction. The last 4 were detected by serologic tests and ultrasonographic examination in connection with mass screening, as the lesions were too small to produce symptoms except in 1 case. The 1st patient had an unresectable lesion and died after 3 years. Hepatectomy was performed in 6 cases: 1 lateral segmentectomy, 4 lobectomies, and 1 partial hepatectomy. The patients are all alive and doing well at 1, 5, 8, 10, 18, and 19 years, respectively, after operation. Early diagnosis and complete removal of the lesion are indispensable to a good prognosis. Alveolar echinococcosis occurs in limited areas, so that mass screening can be effectively performed.