Alveolar echinococcosis (alveolar hydatid disease) is caused by a larval form of Echinococcus multilocularis. Invasive nature of the parasite growth and ability to spread to distant organs and creation of secondary lesions makes alveolar hydatid disease similar to cancer. Alveolar hydatid disease does not have any specific symptoms so the diagnosis is based on imaging study and serology. The case report presents a 75‑years old patient with weakness, weight loss and recurrent fever, that had been diagnosed with tumor in the liver and adrenal gland and recurrent pleural effusion. In the past, the patient was treated with colorectal cancer. In order to determine the etiology of focal lesions, the patient underwent a series of examinations, including positron emission computed tomography (PET‑CT) and magnetic resonance imaging (MRI) of the abdomen, as well as surgical biopsy of the lesion. Histopathological examination of the sample demonstrated abnormalities that may be the result of parasitic infestation. The diagnosis of alveolar echinococcosis was based on clinical picture and positive serologic results.