Ascaris infestation of biliary tree mimicking gallbladder cancer

Abstract

A 51-year-old male presented with jaundice for 2 months. He had a history of acute pancreatitis 4 months before and weight loss of 20 kg. Laboratory tests demonstrated elevated total and direct bilirubin (288.6 μmol/L and 232.4 μmol/L, respectively). CA19-9 was also significantly increased (>1200 U/ml). Ultrasound and magnetic resonance imaging both indicated irregular thickening of gallbladder (Fig. 1). Magnetic resonance cholangio-pancreatography (MRCP) revealed marked dilatation of intrahepatic ducts. Therefore, a diagnosis of gallbladder cancer with hilar invasion was made.