Alvelolar HYDATID DISEASE is caused by E. multilocularis. Human infection occurs at the larval stage of this small tape worm (1.2 to 4.5 mm). In this article we studied ALVEOLAR HYDATID DISEASE in a 50 year old woman who presented with a hepatic mass. Liver biopsy and histopathologic evaluation showed alvelolar HYDATIDosis of the liver. Then resection of the left lobe of liver was done, with medical treatment with oral Albendazole (15 mg/kg/12h) for 6 weeks with 2 week intervals. The drug was continued for 4 courses. 5 year follow up of the patient was satisfactory without any complaint.

Background: ALVEOLAR echinococcosis (AE) is a chronic, rare and sometimes lethal parasitic infection in humans, caused by the larval stage of the fox tapeworm Echinococcus multilocularis. This study aimed to investigate the clinical aspects and treatment outcomes of patients with ALVEOLAR HYDATID DISEASE.Methods: The medical records of patients with ALVEOLAR echinococcosis admitted between 1997 and 2012 were reviewed. Diagnosis was confirmed by physical examination, ultrasonography and CT scanning and MRI. Various treatment techniques were used such as complete liver resection in seven (38.89%) patients, biliary bypass in two (11.11%) patients, laparotomy and tumor biopsy in eight (44.44%) patients and long term medical treatment in one (5.56%) patient. After discharge, all patients were followed to determine the effect of treatment, complications, recurrences and survival.Results: A total of 18 patients with mean age of 46.11±15.14 years (range 23-74 years) were studied. The DISEASE was more prevalent in women than men (78.9% vs 4, 21.1%, P=0.021). Fourteen (77.78%) patients live in Chenaran, a town located in Khorasan, Iran). Death occurred in (22.22%) patients after an average period of 45.70±7.50 months after DISEASE onset. 14 remaining patients survived after a mean follow-up duration of 54.60±29.17 months.Conclusion: Diagnosis of ALVEOLAR echinococcosis should be considered in endemic area. Early diagnosis and treatment is associated with excellent outcome.

HYDATIDsis is a zoonosis transmitted by domestic and wild animals. Two distinct clinical presentations are as followes: unilocular of cystic HYDATID DISEASE and the more malignant form, called ALVEOLAR HYDATID DISEASE.This case report presents a patient who complained of chest pain and hemoptysis and his lung CT scan suggested solid tumor. He was found to have ALVEOLAR diseae which responded to albendazole medical therapy

A 48-year-old man referred with pain and swelling at the upper and middle third of left tibia with a history of previous osseous HYDATID DISEASE three years ago. Despite surgical procedure which was performed in this case, recurrence was observed and repeated exploration with wide resection and oral medical therapy were recommended. Bone HYDATID cyst is an uncommon DISEASE with difficult response to treatment. HYDATID DISEASE should be included in the differential diagnosis of cystic lesions of bone in endemic regions.

Perhaps no other bone infection is more difficult to eradicate, as bone echinococcosis. Unfortunately, despite of several years experience in this regard, we still have not found the solution to this zoonotic infection of bone. Every year, several affected people are visited by many orthopedic surgeons and infectious DISEASE specialists all over the country and in referral hospitals and eventually, the skillful neglect seems to be selected as a last resort by most of these visiting physicians. So here remains an important question to be answered: why are we unable to eradicate bone HYDATIDosis in spite of improvement in our techniques for diagnosis, assessment of the extent of involvement by radiological studies, medical management with new chemotherapeutic agents and surgical resection of the cysts?

A 45-year-old housewife was referred to our center with a two-week history of moderate to severe pain and fullness of the epigastric and left upper quadrant area. She had no history of fever, jaundice, abdominal trauma, weight loss, or other symptoms. She gave a history of epigastric fullness and dyspepsia of one year duration, for which she was taking ranitidine on demand. Physical examination was normal except for the presence of a large, smooth, and nontender mass in the epigastric area extending to the left upper quadrant. Paraclinical investigations, including a complete blood count, liver and kidney function tests, serum lipase, blood chemistry, CA19-9, CEA, urinalysis, and stool examination for ova, parasites, and occult blood were reported normal except for an erythro­cyte sedimentation rate of 50 mm after the first hour and a serum amylase of 300 IU/dL. Chest X-ray was normal. Abdominal ultrasonography revealed a large cystic mass measuring about 15 cm in diameter compatible with a large pseudocyst of the pancreas. An abdominal computerized tomography (CT) scan was taken (Figure 1).