Fascioliasis hepática que simularon tumores hepáticos

Abstract

Two cases of hepatic fascioliasis which simulated hepatic tumors are presented: Patient 1. (42-year-old woman), presented pain in the epigastric and right hypochondrium. US, CAT and MNR suggested a cholangiocarcinoma. She was operated on by practicing hepatic segmentectomy, cholecystectomy and closign of a cholecystogastric fistula. The extirpated hepatic segment presented a tumoral aspect, but its histopathological study revealed numerous granulomas, some of them with F. hepatica eggs and others with Charcot - Leyden crystals. ELISA and complement fixation reaction for fascioliasis resulted positive. Search of F. hepatica eggs in stools was negative. The patient was treated with triclabendazole. Patient 2. (58-year-old woman) also presented pains in the upper hemiabdomen. Hypereosinophilia (32%). Abdominal CAT showed multiple hipondense irregular zones suggesting infiltrative processes in the liver right lobe. The hepatic biopsy, under CAT, eventhough lead to think in a hamartoma, a diagnosis of chronic cholangitis compatible with a parasitic etiology raised. ELISA and complement fixation reaction for fascioliasis were positive. Coproparasitological exams for F. Hapatica resulted negative. She was successfully treated with triclabendazole. Hapatic fascioliasis simulates numerous diseases, among them hepatic tumors.