Echinococcus Multilocularis - Disease Staging

Disease Staging

Alveolar echinococcosis (AE) is a highly lethal helminthic disease in humans, caused by the larval form of the parasitic tapeworm E. multilocularis. The disease represents a serious public threat in China, Siberia, and central Europe. However since the 1990s, the prevalence of the disease seems to be increasing in Europe, not only in the historically endemic areas but its neighboring regions . AE primarily affects the liver by inducing a hepatic disorder similar to liver cancer, therefore becoming extremely dangerous and difficult to diagnose. If the infection metastases, it may spread to any other organ and could be lethal if not treated. The most common treatment for AE is to surgically remove the parasite. Since it is difficult and not always possible to remove the entire parasite, medicine such as Albendazole is utilized to keep the cyst from growing back..

Guided by the Tumor-Node-Metastasis (TNM) system of liver cancer, the European Network for Concerted Surveillance of Alveolar Echinococcosis and the World Health Organization Informal Working Group on Echinococcosis, a clinical classification system has been proposed. This classification system has been designated as the "PNM" system (P = parasitic mass, N = involvement of neighboring organs, M = metastasis). The system was developed by a retrospective analysis of records from 97 patients treated in France and Germany (2 treatment centers). Amongst other characteristics, the system takes into consideration the localization of the parasite in the liver, the extent of lesion involvement, regional involvement, and metastasis.

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