34-year-old patient with an echinococcal cyst in liver segments II/III. (a) Native B-mode ultrasound reveals an inhomogeneous cystic lesion in the left liver lobe (yellow arrows). (b) In contrast-enhanced ultrasound, no enhancement of the cystic lesion is detected (yellow arrows, portal venous phase). Sonomorphological differentials included haemorrhagic cyst or cystic echinococcosis. The sonomorphological appearance in combination with positive serological findings confirmed the diagnosis of cystic echinococcosis. After interdisciplinary evaluation, the patient underwent laparoscopic resection of the liver segments II and III. (c) Hematoxylin and Eosin staining of the echinococcal cyst, 50× magnification. The fibrous tissue (pericyst, black star) surrounding the cuticula (black arrow) is shown.