Korean J Hepatol.  2005 Jun;11(2):169-175.

Four Cases of Hepatic Fascioliasis Mimicking Cholangiocarcinoma

• Kim YH
• Kang KJ
• Kwon JH

Abstract

Human fascioliasis is a zoonosis caused by Fasciola hepatica, and this is a trematode that infests cattle and sheep. Humans are accidental hosts in the life cycle of this parasite. People are infected by ingestion of the water or the raw aquatic vegetables that are contaminated with the metacercaria. This fluke's worldwide distribution occurs in areas where sheep, cattle and goats are raised, and there is a life-cycle niche for this fluke in lymnaeid snails. However, it is a rare disease in Korea. We experienced four human fascioliasis which were difficult to differentiate from hepatic malignancy in three patients, and this was misdiagnosed as common hepatic duct tumor in one patient. The patients manifested only vague abdominal symptoms. Intrahepatic fascioliasis showed multiple ill-defined hypoattenuating lesions and filling defects of the lesion lumens on radiologic study. A striking eosinophilia from the patients' blood was identified and a positive finding of a serum enzyme linked immunosorbent assay for the Fasciola hepatica was also noted in three of four patients. The therapeutic trial with triclabendazole and praziquantel was not successful.

Keyword

Hepatic fascioliasis; Common hepatic duct; Intrahepatic tumor

MeSH Terms

Adult
Bile Duct Neoplasms/*diagnosis
*Bile Ducts, Intrahepatic
Cholangiocarcinoma/*diagnosis
Diagnostic Errors
English Abstract
Fascioliasis/*diagnosis
Female
Humans
Liver Diseases, Parasitic/*diagnosis
Middle Aged