Abstract
RATIONALE: We describe a case of hepatic cyst with intracystic bleeding that was preoperatively misdiagnosed as hepatic echinococcosis. Pain in the right upper quadrant of the abdomen was the first symptom to appear. In addition to highlighting the significance of imaging in distinguishing hepatic cyst with intracystic bleeding from other cystic liver tumors, we also talk about the difficulties and obstacles encountered throughout the diagnosis and treatment of this case. More imaging evidence for the diagnosis of hepatic cyst with intracystic bleeding is anticipated in this patient. PATIENT CONCERNS: A 24-year-old Tibetan female was admitted to the hospital due to swelling and pain in the right upper abdomen for more than 1 month. DIAGNOSES: The patient had a history of living in the epidemic area, serum echinococcosis antibody was positive, and abdominal computed tomography plain enhanced scan showed a low-density cystic space-occupying lesion in the right lobe of the liver, with a high-density mass in the cyst, which was misdiagnosed as cystic hepatic echinococcosis before operation. Postoperative pathological examination confirmed old hemorrhage in hepatic cysts, and no parasitic infectious lesions such as Echinococcus granulosus were found. INTERVENTIONS: After perfecting the relevant preoperative preparation, the patient underwent right hemihepatectomy plus portal vein and vena cava repair. OUTCOMES: The patient was discharged from the hospital 5 days after operation. LESSONS: The differential diagnosis of individuals with a history of residing in an epidemic region and liver space-occupying lesions on imaging should take into account more than only the probability of hepatic echinococcosis, as this case highlights. When making a differential diagnosis of different types of cystic liver tumors, imaging testing is crucial.