OBJECTIVE: Describe the case of echinococcal disease in gynecological practice and point out the complications of its diagnosis. DESIGN: Case report. SETTING: Department of Obstetrics and Gynaecology, Faculty Hospital Trenčín, Slovakia. CASE REPORT: The case is presented in an immunosuppressed patient with peritoneal carcinomatosis, mild Ca 125 elevation and increased CRP presenting as a finding of gynecological etiology with histopathological outcome and conclusion of parasitic disease - echinococcosis (hydatidosis). CONCLUSION: In the differential diagnosis of peritoneal carcinomatosis and ascites, especially in immunosuppressed patients with a positive social (or epidemiological) history, the possibility of rare parasitic diseases such as echinococcosis, which resembles malignant tumors, should be considered.