Presentation
Incidentally detected calcified lesion on USG (not shown here). CT done for further evaluation.
Patient Data
Axial, sagittal, and coronal sections of a non-contrast CT scan of the abdomen (limited sections) show a well-defined hypodense cystic lesion with intralesional serpiginous calcification in the left lobe of liver. Subtle peripheral wall calcification was also noted. Surrounding liver appears normal. No other abnormality was detected in the rest of abdomen
Case Discussion
Most hydatid cysts are asymptomatic and found incidentally 1. Twenty to thirty percent of hydatid cysts have calcification, which is typically ring or curvilinear indicating pericyst calcification. Over the course of the cyst's natural evolution, all its parts, including the internal matrix calcify densely. Complete calcification usually indicates the death of parasite 2.
Hepatic calcifications can be due to an array of pathologic abnormalities, like calcified hematomas, neoplasms, vascular calcifications, biliary calculus, and granulomatous infections and thus needs a pattern recognition approach for characterization 3.
In an asymptomatic subject with no other relevant history, belonging to an echinococcosis endemic region like India 4, the above imaging features are highly suggestive of a calcified intrahepatic hydatid cyst with wall and internal matrix calcification.
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