Week 277: Case 4

1. Presented by Peter Illei, M.D. and prepared by Jeffrey T. Schowinsky, M.D.

This 47-year-old female patient with a history echinococcal cyst that was resected in 1999 developed a relatively asymptomatic fluid-filled hepatic cyst. She presented with episodic nausea and pressure in her epigastric area. MRI scan showed that the cyst had increased in size from approximately 12 cm 1 year ago to approximately 18 to 20 cm now. Due to her symptoms, she elected or surgical management and underwent drainage and excision of the hepatic cyst. Approximately 1.3 liters of fluid was drained from the cyst. The collapsed cyst measured 15 cm in greatest dimension (figure 1).