**Conflict of interest**

*Overview on Echinococcosis*

USG will gradually increase.

In this first 6 months postoperatively, USG is the main follow-up method. It shows both early recurrences and complications related to surgery. In the first few months, USG may show fluid accumulation in the cyst, which is usually seroma and will disappear afterwards. In recurrences, the fluid seen in the cavity in the previous

Recurrence rates after surgery or invasive procedures range from 0 to 15%. The most common cause of recurrence is the scattering of living scolexes into the peritoneal cavity. Even if the patients is going to get operated, albendazole treatment is started 4–6 weeks preoperatively, which significantly reduces the risk of recurrence.

It forms 2–3% of liver cysts. In radiological imaging techniques, it is seen as the cyst wall makes papillary extensions into the liver parenchyma, which may resemble a hepatic tumor that leaks clinically and radiographically with irregular edges and heterogeneous density [18]. This formation is very important because if a part of the liver parenchyma is not resected in the surgery, there may remain a part of the

There is also a PNM staging for alveolar echinococcal disease. P in the PNM shows the state of the parasite in the liver, N shows adjacent organ involvement, and

P1: Peripherally located and without biliary or proximal vascular involvement. P2: Central lesion involving the biliary or proximal vascular structures in a single

P3: Central lesion involving the biliary or proximal vascular structures of two

P4: Any lesion extending along the portal vein, inferior vena cava, or hepatic

*Alveolar* Echinococcus *lesion in right liver lobe shown in abdominal CT scan. Partial calcifications are seen around the lesion and left lobe is hypertrophied. Differential diagnosis with hemangioma is done with biopsy [3].*

The treatment of recurrent cysts is designed as in newly diagnosed cysts.

**9. Alveolar cysts (***E. alveolaris* **=** *E. multilocularis***)**

germinative membrane which will cause recurrences (**Figure 6**).

N: Shows extrahepatic involvement to neighboring organs.

M is for metastasis. Accordingly, PNM staging is as follows: P: Shows the localization of the metacestode in the liver.

PX: Parasitic lesion cannot be evaluated. P0: No parasitic lesion in the liver.

lobes, or involving two hepatic veins, or both.

Nx: Unable to evaluate. N0: No regional involvement.

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**Figure 6.**

lobe.

artery.

The authors declare no conflict of interest.
