Alveolar echinococcosis in a Belgian urban dweller.

Human alveolar echinococcosis is a rare parasitic disease caused by larvae of the tapeworm E. multilocularis that colonizes the intestines of foxes. The disease predominantly affects the liver and mimics slow growing liver cancer. With a mere 13 reports coming mostly from southern rural regions Belgium has so far been spared from the disease. However alveolar echinococcosis appears to be slowly spreading to non-endemic European countries like Belgium and to urban centres. We report the first autochthonous case involving a patient having lived exclusively in downtown Brussels. Heightened awareness by the medical community is necessary to detect this lethal disease at an early curable stage. In patients with an undetermined focal liver lesion--especially if calcified--and no firm evidence of malignancy, serological screening should be performed to exclude alveolar echinococcosis.