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Case 112: Farmer for surgery

A 72 year old farmer is seen in the pre-anaesthetic clinic for a check prior to inguinal hernia repair. A chest xray is requested as he has a smoking history. An interesting incidental discovery is made.

1. What is the finding and the likely diagnosis?

There is a large calcified mass in the right upper quadrant of the abdomen. This most likely represents a calcified and dead hydatid cyst.

2. What further investigations would you arrange?

Further imaging of the abdomen with CT is appropriate to assess the nature of the cyst and the possible presence of other non-calcified and viable cysts. Serological testing for Echinococcus may also be useful.