A Case report, imitating metastatic liver cancer radiologicaly: Fasciola Hepatica

Fasciola hepatica, a zoonotic liver fluke, can also cause disease in humans. Common symptoms are epigastric pain, upper abdominal pain and malaise. Fever and arthralgia are common in acute fascioliasis. Eosinophilia is the predominant laboratory finding, especially in patients with the acute form of the disease. Diagnosis is not easy, as physicians rarely encounter this disease. A 25 years old man was admitted to the clinic with severe right upper abdominal pain. There was a two-month history of mild jaundince, trembling and fever. Abnormal laboratory findings were as follows: alanin aminotranspherase: 77U/L, aspartat aminotranspherase: 55U/L, alkalen phosphatase: 648 U/L (N: 11-49) gamma glutamyl transpeptidase: 142 U/L (N: 11-49). Abdomen ultrasonography and magnetic resonance imaging (MRI) revealed multiple, 1,5 cm sized lesions of which biggest was 1.5 cm, compatible with metastasis. Other systems were normal. Since 40 % eosinophilias were present in peripheral blood, fecal examination
was performed but no parasite and parasite eggs were detected. Liver biopsy that was performed for metastatic liver cancer suspicion revealed fasciola hepatica. Fasciola
hepatica antibody result was 1: 80 positive. The patient was administered triclabendazol 10 mg/kg for fasciola hepatica diagnosis. After 3 months, the symptoms were improved and laboratory and imaging results returned completely back to normal. Patients with eosinophilia and abdominal pain should be evaluated for F. hepatica infestation by parasitological, radiological and serological tests.

Radyolojik olarak metastatik karaciðer tümörü ile karýþan bir olgu: Fasciola hepatica