Multimodal imaging for the diagnosis of cardiac alveolar echinococcosis: a case report

Background : Primary cardiac echinococcosis is rare, and cardiac alveolar echinococcosis is even rarer and more unusual. Reported cases of this disease are extremely limited, and multimodal imaging provides an important guide to treatment and decision-making. We report a case of cardiac alveolar echinococcosis. Case summary : A 31-year-old male patient with no specific medical history was found to have a cardiac space-occupying lesion on physical examination one day earlier. Transthoracic echocardiography showed a cystic mass anterior to the right lateral aspect of the right atrium, which did not show enhancement on the enhanced scan. Multidetector computed tomography and cardiac magnetic resonance showed a cystic space-occupying lesion in the right lateral aspect of the right atrium, with mild enhancement of the edges of the lesion and multiple small vesicles on the enhancement scan. Surgery was performed on suspicion of cardiac alveolar echinococcosis, and the lesion was successfully excised. Ultimately, postoperative histopathologic examination revealed cardiac alveolar echinococcosis. The patient recovered well and was discharged with regular postoperative oral albendazole tablets and regular follow-up reviews. Conclusion : We report a case of cardiac alveolar echinococcosis with multimodal imaging features and therapeutic strategies, an extremely rare cardiac occupying disease. Multimodal imaging can be very helpful in diagnosing the disease; however, surgical resection with histopathologic diagnosis is essential. Appropriate postoperative treatment and follow-up are based on histologic findings. This rare case emphasizes the integrated diagnosis of cardiac alveolar echinococcosis with clinical, multimodal imaging and pathologic data.