Schematic representation of the natural history of hepatic CE and suggested treatments. Black arrows indicate proposed cyst natural history based on clinical observation (Brunetti E., unpublished). Solid black arrows indicate natural evolution toward inactivation; black dashed arrows indicate evolution of therapy-unresponsive chronic stages. US images: cyst ultrasound classifications according to WHO-IWGE (in bold) and Gharbi . As WHO-IWGE stage CE3b had not been explicitly described by Gharbi it is generally considered type III . Gray boxes: suggested stage-specific approach to uncomplicated hepatic CE [4, 11, 12]. ABZ = Albendazole; PAIR = Puncture, Aspiration, Injection of scolecidal agent, Re-aspiration; PC = Permanent Catheterization.