Hepatic echinococcosis: Clinical and therapeutic aspects

Table 1 Hydatid disease epidemiology and characteristics[6,7]

	Cystic echinococcosis	Alveolar echinococcosis
Causative agent	E. granulosus	E. multilocularis
Definitive hosts	Dogs and other canids (coyotes, dingoes, red foxes)	Red foxes, arctic foxes, coyotes, dogs and cats
Intermediate hosts	Ungulates	Rodents
Geographic distribution	Worldwide	North America, northern and central Eurasia
Worldwide incidence	1-200/100  000	0.03-1.2/100  000
Organ localization	Mainly liver and lungs	Mainly liver
Characteristics of hydatid lesions	Young cysts: spherical, fluid-filled, unilocular vesicles (diameter: 1-15 cm) Old cysts: internal septations, daughter cysts Three-layered structure: germinal layer, laminated layer, pericyst	Alveolar-like pattern, with numerous vesicles (< 1 mm up to 15 cm in diameter) and surrounding dense connective tissue, no cyst fluid, sometimes central necrosis
Type of growth in human organs	Concentric expansion	Tumor-like, infiltrative behaviour
Therapeutic options	Surgery, PT (especially PAIR), chemotherapy	Surgery, chemotherapy, EPIs

PTs: Percutaneous treatments; PAIR: Puncture, aspiration, injection, re-aspiration; EPIs : Endoscopic percutaneous interventions.