Fascioliasis presenting as colon cancer liver metastasis on 18Ffluorodeoxyglucose positron emission tomography/computed tomography: A case report  

作　　者：Sami Akbulut Egemen Ozdemir Emine Samdanci Selver Unsal Murat Harputluoglu Sezai Yilmaz 

机构地区：[1]Liver Transplant Institute, Inonu University, Malatya 44280, Turkey [2]Department of Surgery, Inonu University Faculty of Medicine, Malatya 44280, Turkey [3]Department of Pathology, Inonu University Faculty of Medicine, Malatya 44280, Turkey [4]Department of Nursing Service, Liver Transplant Institute, Inonu University, Malatya 44280, Turkey [5]Department of Gastroenterology, Inonu University Faculty of Medicine, Malatya 44280, Turkey

出　　处：《World Journal of Hepatology》2019年第8期656-662,共7页世界肝病学杂志（英文版）（电子版）

摘　　要：BACKGROUND Fascioliasis is caused by watercress and similar freshwater plants or drinking water or beverages contaminated with metacercariae. Fascioliasis can radiologically mimic many primary or metastatic liver tumors. Herein, we aimed to present the treatment process of a patient with fascioliasis mimicking colon cancer liver metastasis. CASE SUMMARY A 35-year-old woman who underwent right hemicolectomy due to cecum cancer was referred to our clinic for management of colon cancer liver metastasis. Both computed tomography and 18F-fluorodeoxyglucose positron emission tomography revealed several tumoral lesions localized in the right lobe of the liver. After a 6-course FOLFOX (folinic acid, fluorouracil, oxaliplatin) and bevacizumab regimen, the hypermetabolic state on both liver and abdominal lymph nodes continued, and chemotherapy was extended to a 12-course regimen. The patient was referred to our institute when the liver lesions were detected to be larger on dynamic liver magnetic resonance imaging 6 weeks after completion of chemotherapy. Right hepatectomy was performed, and histopathological examination was compatible with fascioliasis. Fasciola hepatica IgG enzyme-linked immunosorbent assay was positive. The patient was administered two doses of triclabendazole (10 mg/kg/dose) 24 h apart. During the follow-up period, dilatation was detected in the common bile duct, and Fasciola parasites were extracted from the common bile duct by endoscopic retrograde cholangiopancreatography (ERCP). Triclabendazole was administered to the patient after ERCP. CONCLUSION Parasitic diseases, such as those caused by Fasciola hepatica, should be kept in mind in the differential diagnosis of primary or metastatic liver tumors, such as colorectal cancer liver metastasis, in patients living in endemic areas.BACKGROUND Fascioliasis is caused by watercress and similar freshwater plants or drinking water or beverages contaminated with metacercariae. Fascioliasis can radiologically mimic many primary or metastatic liver tumors. Herein, we aimed to present the treatment process of a patient with fascioliasis mimicking colon cancer liver metastasis.CASE SUMMARY A 35-year-old woman who underwent right hemicolectomy due to cecum cancer was referred to our clinic for management of colon cancer liver metastasis. Both computed tomography and 18 F-fluorodeoxyglucose positron emission tomography revealed several tumoral lesions localized in the right lobe of the liver. After a 6-course FOLFOX(folinic acid, fluorouracil, oxaliplatin) and bevacizumab regimen, the hypermetabolic state on both liver and abdominal lymph nodes continued, and chemotherapy was extended to a 12-course regimen. The patient was referred to our institute when the liver lesions were detected to be larger on dynamic liver magnetic resonance imaging 6 weeks after completion of chemotherapy. Right hepatectomy was performed, andhistopathological examination was compatible with fascioliasis. Fasciola hepatica Ig G enzyme-linked immunosorbent assay was positive. The patient was administered two doses of triclabendazole(10 mg/kg/dose) 24 h apart. During the follow-up period, dilatation was detected in the common bile duct, and Fasciola parasites were extracted from the common bile duct by endoscopic retrograde cholangiopancreatography(ERCP). Triclabendazole was administered to the patient after ERCP.CONCLUSION Parasitic diseases, such as those caused by Fasciola hepatica, should be kept in mind in the differential diagnosis of primary or metastatic liver tumors, such as colorectal cancer liver metastasis, in patients living in endemic areas.

关 键 词：COLON cancer liver metastasis FASCIOLA hepatica POSITRON emission tomography MISDIAGNOSIS Case report 

分 类 号：R[医药卫生]