| Summary: | Abstract Cystic echinococcosis (CE) is a widely endemic helminthic disease caused by infection with metacestodes (larval stage) of the Echinococcus granulosus tapeworm. E. granulosus are common parasites in certain parts of the world, and are present on every continent with the exception of Antarctica. As a result, a large number of people are affected by CE. The increased emigration of populations from endemic areas where prevalence rates are as high as 5-10% and the relatively quiescent clinical course of CE pose challenges for accurate and timely diagnoses. Upon infection with CE, cyst formation mainly occurs in the liver (70%). Diagnosis involves serum serologic testing for antibodies against hydatid antigens, but preferably with imaging by ultrasound or CT/ MRI. Treatment methods include chemotherapy with benzimidazole carbamates and/or surgical approaches, including percutaneous aspiration injection and reaspiration. The success of these methods is influenced by the stage and location of hepatic cysts. However, CE can be clinically silent, and has a high risk for recurrence. It is important to consider the echinococcal parasite in the differential diagnosis of liver cystic lesions, especially in patients of foreign origin, and to perform appropriate long-term follow-ups. The aim of this review is to highlight the epidemiology, natural history, diagnostic methods, and treatment of liver disease caused by E. granulosus. Host/parasite life cycle Echinococcus granulosus is a small tapeworm that typically infects carnivores, such as dogs, foxes, and wolves, after the consumption of offal from infected intermediate hosts, such as sheep or pigs. Upon entering the small intestine, the parasite remains firmly attached to the mucosa, and later sheds gravid proglottids that are excreted in the infected animal's feces. 1 Within each proglottid, there are hundreds of eggs. These eggs can then be ingested by intermediate hosts where they mature into cysts and daughter cysts, such as in sheep that acquire the infection ...
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