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Table 2 Therapeutic features of human alveolar echinococcosis cohort patients in Hungary(2003–2018)

From: Emerging human alveolar echinococcosis in Hungary (2003–2018): a retrospective case series analysis from a multi-centre study

case no. 1 2 3 4
antiparasitic drug tx (duration in months) ABZ (3) 10.2004–12.2004 ABZ (162) continuously since
07.2005
ABZ (12) 11.2008 –
01.2009 and 06.2016–03.2017
surgery exploration –unresectable exploration,
fenestration, marsupialisation
EPI PTD (2x), ERCP
follow-up period in months 27 177 162 124
radiomorphology on final control, largest diameter of AE lesion(s) in mm (date) CT (04.2005) – pseudocystic AE lesion in left lobe 49 mm, two more AE lesions in right lobe, 35 mm and 24 mm US (09.2014) stabilization MRI (12.2018) stabilization US (12.2018) residual cavity in SIV 70 mm, giant biloma in porta hepatis
PNM at final imaging P1N0Mx P1NxMx P2N1Mx P3N0Mx
complications elevated GGT (136), ALP (621), sebi (36,3) central biliary obstruction, cholangitis, biloma, bile-leaking
outcome progression, AE unrelated death stabilization stabilization progression
case no. 5 6 7 8
antiparasitic drug tx (duration in months) ABZ (5) 02.2012–07.2012 ABZ (67) continuously since 06.2013 ABZ (24) postoperatively
surgery marsupialization, drainage extended right hemihepatectomy segmentectomy
EPI ERCP – biliary stent implantation, nasobiliary stent
follow-up period in months 9 84 69 51
radiomorphology on final control, largest diameter of AE lesion(s) in mm (date) US (11.2011) residual cavity 45 mm, atrophy of right lobe US (02.2018) no recurrence MRI (10.2018) and US (10.2018), 109 mm US (07.2018) no recurrence
PNM at final imaging P4N0Mx P0N0Mx P4N0Mx P0N0M0
complications central biliary obstruction, bile-leaking, bilio-peritoneal fistula, injury of bileducts during surgical manipulation, cachexia postoperative peritonitis, haematoma, bile-leaking, Kehr-drainage v. cava inferior compression
outcome progression, AE related death no recurrence stabilization no recurrence
case no. 9 10 11 12
antiparasitic drug tx (duration in months) ABZ (3) lowered dose intermittently in 2016, finally ceased ABZ (30) continuously since 07.2016 ABZ (21) postoperatively ABZ (3) 09.2017–11.2017
surgery segmentectomy
EPI
follow-up period in months 36 30 20 18
radiomorphology on final control, largest diameter of AE lesion(s) in mm (date) MRI (10.2018), CT (10.2018) no progression in liver, new pulmonary micronodules (09.2017) MRI (11.2018) SIV 70 mm, progression MRI (06.2018), US (10.2018) no recurrence US (07.2018) AE lesion in left lobe 65 mm, AE lesion in right lobe 44 mm
PNM at final imaging P3N0Mx P1N0Mx P0N0Mx P2N0Mx
complications ABZ hepatotoxicity and allergic reactions, undignified pulmonary microlesions
outcome stabilization progression no recurrence progression
case no. 13 14 15 16
antiparasitic drug tx (duration in months) ABZ (12) continuously since 01.2018 ABZ (12) continuously since 01.2018 ABZ (3) 06.2018–09.2018
surgery right hemihepatectomy, exstirpation of d. choledochus and cholecystectomy, hepaticojejunostomia explorative laparotomy right hemihepatectomy, exstirpation of d. choledochus and cholecystectomy, hepaticojejunostomia
EPI ERCP ERCP (2x), stent implantation (2x) ERCP, stent implantation, PTD (2x)
follow-up period in months 13 12 5 1
radiomorphology on final control, largest diameter of AE lesion(s) in mm (date) MRI (10.2018) AE lesion in SV 79 mm CT (10.2018) no recurrence US (05.2018) 120 mm AE lesion occupying left lobe, ascites, dilatated intrahepatic bileducts
PNM at final imaging P4N0Mx P0N1Mx P4N1Mx P0N0Mx
complications thrombosis and parasitic infiltration of right v. portae, compression of d. hepaticus dexter leukopenia, hairloss, haematoma in residual left lobe (32 mm) and undignified pulmonary microlesions compression of d. hepaticus communis, peritonitis, cholangiogen sepsis compression of d. hepaticus communis, abscessus hepatis, liver insufficiency, septic shock
outcome stabilization no recurrence progression, AE related death progression, AE related death
  1. E.m Echinococcus multilocularis, AE alveolar echinococcosis, CE cystic echinococcosis, v vena, d ductus, AST aspartate aminotransferase, ALT alanine aminotransferase, GGT gamma-glutamyltransferase, ALP alkaline phosphatase, sebi serum bilirubin, US ultrasound, CT computer tomography, MRI magnetic resonance imaging, IH immunohistochemistry using monoclonal antibody mAbEm2G11, PCR polymerase chain reaction, tx treatment, EPI endoscopic and percutaneous interventions, ERCP endoscopic retrograde cholangiopancreatography, PTC percutaneous transhepatic cholangiography, PTD percutaneous transhepatic drainage, FNAB fine needle aspiration biopsy, S liver segment, ABZ albendazole, HCC hepatocellular carcinoma
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