{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,4]],"date-time":"2026-04-04T02:46:08Z","timestamp":1775270768070,"version":"3.50.1"},"reference-count":28,"publisher":"American Academy of Pediatrics (AAP)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,12,1]]},"abstract":"<jats:p>Because of mostly asymptomatic cyst growth and often-neglected nonspecific low-grade symptoms, many cases of cystic echinococcosis (CE) caused by Echinococcus granulosus in the pediatric population are diagnosed at school age, in an advanced and even complicated stage. In 2003, after 5 months of intermittent dull upper-right abdominal pain and nausea, a 13-year-old boy was diagnosed with massive liver CE, with \u223c20 round-shaped double-walled medium-sized infective cysts, which permeated the whole liver. Because of their wide distribution across the liver tissue and the risky superficial position of some cysts, liver transplantation emerged as the optimal therapeutic option. Despite being described as only an exceptionally used method for CE, we subjected our patient on 4 occasions to a radiofrequency energy thermoablation (RFT) procedure similar to the one used for malignant neoplasms. In total, 9 superficially situated cysts were initially treated with RFT by using a 14-gauge outer needle and a temperature of 70\u00b0C for 8 minutes per cyst, and the remaining cysts were treated with the puncture-aspiration-instillation-reaspiration procedure, along with albendazole (15 mg\/kg per day) therapy, for a period of 20 months. After 2 years of follow-up, 4 residual small-sized semisolidified cysts were seen in the liver, and the patient showed no signs of relapse. Although not routinely used, RFT, along with puncture-aspiration-instillation-reaspiration and prolonged albendazole therapy, has shown good tolerability and long-term efficacy in the treatment of multiple infective CE, which could suggest the usefulness of the RFT method beyond salvage situations in pediatric patients.<\/jats:p>","DOI":"10.1542\/peds.2018-1254","type":"journal-article","created":{"date-parts":[[2018,11,14]],"date-time":"2018-11-14T03:24:18Z","timestamp":1542165858000},"source":"Crossref","is-referenced-by-count":4,"title":["Repeated Percutaneous Treatment of Massive Hepatic Cystic Echinococcosis in a Child"],"prefix":"10.1542","volume":"142","author":[{"given":"Mirjana","family":"Balen Topi\u0107","sequence":"first","affiliation":[{"name":"University Hospital for Infectious Diseases Dr Fran Mihaljevi\u0107, Zagreb, Croatia;"},{"name":"Department of Infectious Diseases, School of Medicine and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomislava","family":"Skuhala","sequence":"additional","affiliation":[{"name":"University Hospital for Infectious Diseases Dr Fran Mihaljevi\u0107, Zagreb, Croatia;"},{"name":"Department of Infectious Diseases, School of Dental Medicine, University of Zagreb, Zagreb, Croatia; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bo\u0161ko","family":"Desnica","sequence":"additional","affiliation":[{"name":"University Hospital for Infectious Diseases Dr Fran Mihaljevi\u0107, Zagreb, Croatia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Klaudija","family":"Vi\u0161kovi\u0107","sequence":"additional","affiliation":[{"name":"University Hospital for Infectious Diseases Dr Fran Mihaljevi\u0107, Zagreb, Croatia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Drinkovi\u0107","sequence":"additional","affiliation":[{"name":"Drinkovi\u0107 Polyclinic, Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[2018,12,1]]},"reference":[{"issue":"3","key":"2021120913462847800_B1","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1016\/S0891-5520(20)30545-6","article-title":"Echinococcal disease.","volume":"7","author":"Kammerer","year":"1993","journal-title":"Infect Dis Clin North Am"},{"issue":"2","key":"2021120913462847800_B2","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1016\/S0001-706X(02)00223-1","article-title":"International classification of ultrasound images in cystic echinococcosis for application in clinical and field epidemiological settings.","volume":"85","author":"Macpherson","year":"2003","journal-title":"Acta Trop"},{"issue":"3","key":"2021120913462847800_B3","doi-asserted-by":"crossref","first-page":"674","DOI":"10.4269\/ajtmh.16-0479","article-title":"Epidemiology of echinococcosis among schoolchildren in Golog Tibetan Autonomous Prefecture, Qinghai, China.","volume":"96","author":"Cai","year":"2017","journal-title":"Am J Trop Med Hyg"},{"issue":"2","key":"2021120913462847800_B4","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1016\/j.ijid.2008.03.037","article-title":"Echinococcosis: a review.","volume":"13","author":"Moro","year":"2009","journal-title":"Int J Infect Dis"},{"issue":"7","key":"2021120913462847800_B5","doi-asserted-by":"crossref","first-page":"1423","DOI":"10.1007\/s10096-015-2368-z","article-title":"Cystic echinococcosis in Bulgaria 1996-2013, with emphasis on childhood infections.","volume":"34","author":"Jordanova","year":"2015","journal-title":"Eur J Clin Microbiol Infect Dis"},{"issue":"9","key":"2021120913462847800_B6","doi-asserted-by":"crossref","first-page":"e0160472","DOI":"10.1371\/journal.pone.0160472","article-title":"Abdominal cystic echinococcosis treated with albendazole. A pediatric cohort study.","volume":"11","author":"Moroni","year":"2016","journal-title":"PLoS One"},{"issue":"3","key":"2021120913462847800_B7","first-page":"385","article-title":"Liver hydatid cyst in children (a 14-year review).","volume":"21","author":"Mirshemirani","year":"2011","journal-title":"Iran J Pediatr"},{"issue":"1\u20132","key":"2021120913462847800_B8","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1016\/S0001-706X(96)00642-0","article-title":"Use of PAIR in human cystic echinococcosis.","volume":"64","author":"Filice","year":"1997","journal-title":"Acta Trop"},{"issue":"9291","key":"2021120913462847800_B9","doi-asserted-by":"crossref","first-page":"1464","DOI":"10.1016\/S0140-6736(01)06518-7","article-title":"Radiofrequency thermal ablation of echinococcal liver cysts.","volume":"358","author":"Brunetti","year":"2001","journal-title":"Lancet"},{"key":"2021120913462847800_B10","doi-asserted-by":"crossref","first-page":"953","DOI":"10.12659\/AJCR.904432","article-title":"Treatment of hepatic hydatid cyst in a 7-year-old boy using a new type of radiofrequency ablation electrode.","volume":"18","author":"Botsa","year":"2017","journal-title":"Am J Case Rep"},{"issue":"2","key":"2021120913462847800_B11","doi-asserted-by":"crossref","first-page":"146","DOI":"10.3325\/cmj.2014.55.146","article-title":"Albendazolesulphoxide concentrations in plasma and hydatid cyst and prediction of parasitological and clinical outcomes in patients with liver hydatidosis caused by Echinococcus granulosus.","volume":"55","author":"Skuhala","year":"2014","journal-title":"Croat Med J"},{"key":"2021120913462847800_B12","unstructured":"WHO Informal Working Group on Echinococcosis . Puncture, Aspiration, Injection, Re-Aspiration: An Option for the Treatment of Cystic Echinococcosis. Geneva, Switzerland: World Health Organization; \u200e2001. Available at: http:\/\/apps.who.int\/iris\/handle\/10665\/67207. Accessed March 7, 2018"},{"key":"2021120913462847800_B13","first-page":"59","article-title":"Pulmonary hydatid cysts in children.","volume":"9","author":"Tuncer","year":"2000","journal-title":"Ann Med Sci"},{"issue":"3","key":"2021120913462847800_B14","first-page":"329","article-title":"Hydatid disease in children: a different pattern than adults.","volume":"22","author":"Talaiezadeh","year":"2006","journal-title":"Pak J Med Sci"},{"issue":"1","key":"2021120913462847800_B15","first-page":"5","article-title":"Our results in surgical treatment in hydatid cyst of the lungs.","volume":"4","author":"Sehitogullari","year":"2007","journal-title":"Eur J Gen Med"},{"issue":"5","key":"2021120913462847800_B16","first-page":"428","article-title":"Hydatid disease in Iranian children.","volume":"40","author":"Mamishi","year":"2007","journal-title":"J Microbiol Immunol Infect"},{"issue":"2","key":"2021120913462847800_B17","first-page":"98","article-title":"Hydatid cyst in children.","volume":"6","author":"Tantawy","year":"2010","journal-title":"Ann Pediatr Surg"},{"issue":"4","key":"2021120913462847800_B18","doi-asserted-by":"crossref","first-page":"123","DOI":"10.4103\/0972-9941.38905","article-title":"Thoracoscopic excision of mediastinal cysts in children.","volume":"3","author":"Jain","year":"2007","journal-title":"J Minim Access Surg"},{"issue":"1","key":"2021120913462847800_B19","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.actatropica.2009.11.001","article-title":"Expert consensus for the diagnosis and treatment of cystic and alveolar echinococcosis in humans.","volume":"114","author":"Brunetti","year":"2010","journal-title":"Acta Trop"},{"issue":"10","key":"2021120913462847800_B20","doi-asserted-by":"crossref","first-page":"e1880","DOI":"10.1371\/journal.pntd.0001880","article-title":"Diagnosing and staging of cystic echinococcosis: how do CT and MRI perform in comparison to ultrasound?","volume":"6","author":"Stojkovic","year":"2012","journal-title":"PLoS Negl Trop Dis"},{"issue":"2","key":"2021120913462847800_B21","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1086\/520205","article-title":"Long-term evaluation of patients with hydatidosis treated with benzimidazole carbamates.","volume":"29","author":"Franchi","year":"1999","journal-title":"Clin Infect Dis"},{"issue":"3","key":"2021120913462847800_B22","doi-asserted-by":"crossref","first-page":"627","DOI":"10.1148\/radiology.155.3.3890001","article-title":"Hepatic echinococcal cyst: successful percutaneous drainage.","volume":"155","author":"Mueller","year":"1985","journal-title":"Radiology"},{"issue":"7","key":"2021120913462847800_B23","doi-asserted-by":"crossref","first-page":"2225","DOI":"10.1016\/S0002-9270(01)02449-2","article-title":"A new percutaneous approach for the treatment of hydatid cysts of the liver.","volume":"96","author":"\u00d6rmeci","year":"2001","journal-title":"Am J Gastroenterol"},{"issue":"2","key":"2021120913462847800_B24","doi-asserted-by":"crossref","first-page":"77","DOI":"10.5152\/tpd.2016.4264","article-title":"An alternative method for percutaneous treatment of hydatid cysts: PAI technique.","volume":"40","author":"\u00d6zdil","year":"2016","journal-title":"Turkiye Parazitol Derg"},{"issue":"5","key":"2021120913462847800_B25","doi-asserted-by":"crossref","first-page":"718","DOI":"10.1136\/gut.50.5.718","article-title":"Percutaneous evacuation (PEVAC) of multivesicular echinococcal cysts with or without cystobiliary fistulas which contain non-drainable material: first results of a modified PAIR method.","volume":"50","author":"Schipper","year":"2002","journal-title":"Gut"},{"issue":"8\u20139","key":"2021120913462847800_B26","doi-asserted-by":"crossref","first-page":"1107","DOI":"10.1016\/S0399-8320(06)73367-X","article-title":"Percutaneous treatment of a complex hydatid cyst of the liver under sonographic control: a cautionary note.","volume":"30","author":"Brunetti","year":"2006","journal-title":"Gastroenterol Clin Biol"},{"issue":"2","key":"2021120913462847800_B27","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1016\/S0399-8320(05)80735-3","article-title":"Percutaneous treatment of a complex hydatid cyst of the liver under sonographic control. Report of the first case.","volume":"29","author":"Bastid","year":"2005","journal-title":"Gastroenterol Clin Biol"},{"key":"2021120913462847800_B28","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1051\/parasite\/2014071","article-title":"Non-surgical and non-chemical attempts to treat echinococcosis: do they work?","volume":"21","author":"Tamarozzi","year":"2014","journal-title":"Parasite"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/doi\/10.1542\/peds.2018-1254\/1075739\/peds_20181254.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/doi\/10.1542\/peds.2018-1254\/1075739\/peds_20181254.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,4]],"date-time":"2026-04-04T01:49:54Z","timestamp":1775267394000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/142\/6\/e20181254\/37471\/Repeated-Percutaneous-Treatment-of-Massive-Hepatic"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,12,1]]},"references-count":28,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2018,12,1]]},"published-print":{"date-parts":[[2018,12,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.2018-1254","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"value":"0031-4005","type":"print"},{"value":"1098-4275","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,12,1]]},"article-number":"e20181254"}}