Treatment of combined hepatic with cerebral alveolar echinococcosis in 11 cases

Abulaiti ADILAI; Xinfeng ZHANG; Taxifulati NIJIATI; Xuean YANG; Qiang GUO; Aji TUERGANAILI; Yingmei SHAO; Ahan AYIFUHAN

ABSTRACT

Objective:

To analyze the treatment and the impact of brain metastases on patients with hepatic alveolar hydatid disease.

Methods:

The data of 11 patients with hepatic alveolar hydatidosis with brain metastases treated at the First Affiliated Hospital of Xinjiang Medical University from January 2014 to December 2019 were retrospectively analyzed. There were 7 males and 4 females. The age range was 19~49 years, with an average of 34 years. Of 11 patients, 7 were treated with surgery combined with drugs and 4 with drugs only. Analyze the treatment and results of patients.

Results:

Of the 7 patients who were treated with surgery and drugs, 2 patients underwent hepatectomy. They were treated with regular postoperative oral medication and were well on follow-up. Three patients underwent only brain surgery. On follow-up from 1 to 3 years, one patient developed pneumonia with atelectasis, another patient developed ascites and jaundice with physical decline. The third patient was stable and had an independent life. Two patients underwent partial hepatectomy and hydatidectomy, with one patient requiring repeated hydatidectomies. On follow-up for one of these 2 patients for 5 years, the patient was home bound and could not take care of himself. The other patient was followed up for 3 years and was stable, alive and able of self-care. Four patients were treated with albendazole liposome, including one patient who developed ascites, a second one with weight loss, physical decline, limb edema and a third one with pleural effusion, pelvic effusion and pneumonia. These patients were still alive with improvement of symptoms on supportive treatment.

Conclusion:

The treatment of hepatic alveolar hydatidosis with brain metastases is still mainly surgery and anti-hydatid drugs. The prognosis of most patients was poor. The surgical principle is neurosurgery first, followed by surgery on liver, lung, spleen and other organs involved by hydatid disease.