Long-term outcome of asymptomatic liver hydatidosis

Background/Aims: The aim of this study was to determine the outcome of asym ptomatic liver hydatid cysts in a cohort of 33 out of 59 carriers by evalua ting clinical and ultrasonographic (US) changes 10-12 years after initial d iagnosis. Methods: We compared US features and cyst size with the original descriptio ns from 1984-1986. Patients were questioned about hydatid-related symptoms and signs. Results: Thirty-three of the 59 carriers could be reevaluated, five (15.2%) of whom had undergone surgery without presenting symptoms, while of 28 uno perated cases, 21 (75%) remained asymptomatic. Of the unoperated cases eval uated by US, in 8/14 (57.1%) there were no modifications in cyst size durin g the le 12-year period, in five (35.7%) growth was slight (<3 cm) and in o ne (7.1%) the cyst grew 4 cm. Mean cyst growth in all 14 cases was 0.7 cm. Conclusions: Despite the limited number of cases, our results show that mos t asymptomatic liver hydatid cases (75%) remain symptom-free for more than 10 years, regardless of cyst size or type. We believe that such carriers ar e at low risk of developing complications, so that it is difficult to estab lish specific rules for their therapy if any. Longitudinal follow-up of lar ger series of asymptomatic hepatic hydatidosis cases is essential to gain a deeper insight into the natural history of such patients, and to draw up c omprehensive guidelines for treatment.