Pathology in Practice: Systemic calcification in a case of canine alveolar echinococcosis (Echinococcus multilocularis)

Alveolar echinococcosis is the formation of large destructive and progressive masses within the liver due to infection with metacestode larvae of Echinococcus multilocularis. Such infections classically occur within small rodent intermediate hosts, however, many species, including humans and domestic canids, have the potential to act as accidental or aberrant intermediate hosts with severe consequences. We report on a case of canine alveolar echinococcosis in a 19-month-old, spayed-female Shepherd cross that presented for acute lethargy and inappetence. Abdominal ultrasound and liver biopsies confirmed the presence of cystic liver masses containing rare cestode protoscolices. Unique to this case was the presence of mineralization within several organ systems including the heart, diaphragm and tongue. Histologic examination revealed features suggestive of both metastatic mineralization and calciphylaxis. Lingual lesions were large enough to be apparent clinically. Consequently, recognition of systemic mineralization as a potential sequela of alveolar echinococcosis may aid in early detection of this condition