| Summary: | Taiwan is nearly free from hydatid disease. We report a case of hydatid cyst of the liver in a 37-year-old man who originally lived in India and had migrated to Taiwan 2 years earlier. He presented with right upper quadrant pain and intermittent low-grade fever. Both sonography and computed tomography (CT) demonstrated a cystic lesion with vesicles at its periphery in segments 6 and 7 of the liver. A hydatid cyst was diagnosed. The patient underwent radical excision of the cyst with total removal without opening the wall. He also received pre- and postoperative oral mebendazole. Pathology showed a hydatid cyst consisting of three layers: the inner single nucleated geminal layer, the middle acellular laminated layer, and the outer pericyst originating from inflammatory and hepatic cells. This case highlights that accurate preoperative diagnosis of hydatid disease can be made from personal history, typical sonography and CT study in non-endemic areas.
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