[Toxocariasis mimicking liver tumor].

Presse Med

Service des maladies digestives, Hôpital d'Instruction des Armées Legouest, Metz-Armées (57).

Published: December 2005

Introduction: Toxocariasis is a common helminth infection that causes visceral larva migrans in humans. It has a wide and varied clinical spectrum.

Case: A 60-year-old woman consulted after 6 months of recurrent biliary pain with fever. Laboratory tests showed moderate disturbance of liver enzymes and hypereosinophilia (10 400/mm3). Imaging studies revealed a pseudotumor in hepatic segment IV, hyperechoic in abdominal ultrasound and low density in computed tomography. The diagnostic conclusion after ultrasound-guided liver biopsy was unspecific granulomatous hepatitis and eosinophilic infiltrate. The course of the antibody titer to Toxocara canis finally resulted in a diagnosis of Toxocara infection. Outcome was good following treatment with diethylcarbamazine.

Discussion: Some clinical features of liver toxocariasis can mimic tumors and may be interpreted histologically as granulomatous hepatitis, eosinophilic infiltrate of the hepatic portal vein, and/or necrotizing eosinophilic abscesses. Treatment is not yet well codified, but the symptomatic forms call for albendazole or diethylcarbamazine.

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http://dx.doi.org/10.1016/s0755-4982(05)84257-5DOI Listing

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