Multiple Hypodense Liver Tumors: Unusual Case of a Spontaneously Healed Echinococcosis

A 62 year old woman suffered from unspecific upper abdominal pain. Abdominal imaging showed multiple liver tumors highly suspicious for malignancy. Although a first needle biopsy was suggestive for an echinoccocus cyst, repeated serologic testing for echinococcosis was negative. Only after surgical resection of one tumor nodule, a spontaneously healed Echinococcus multilocularis could be diagnosed.
Therefore echinococcosis should always be considered as a possible differential diagnosis of liver tumors in Central Europe. Spontaneous death of Echinococcus multilocularis hydatids as described in this case is rare, but might be underreported in the literature.