[Toxocariasis mimicking liver tumor].
BACKGROUND
Toxocariasis is a common helminth infection that causes visceral larva migrans in humans. It has a wide and varied clinical spectrum.


METHODS
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.


CONCLUSIONS
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.
Rey
P
P
Service des maladies digestives, Hôpital d'Instruction des Armées Legouest, Metz-Armées (57). philippe.rey@santesurf.com
Bredin
C
C
Carrere
C
C
Froment
N
N
Casassus-Builhe
D
D
D003937:Diagnosis, Differential; D004049:Diethylcarbamazine / Q000627:therapeutic use; D004802:Eosinophilia / Q000469:parasitology; D005260:Female; D005369:Filaricides / Q000627:therapeutic use; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis; D008875:Middle Aged; D014120:Toxocariasis / Q000175:diagnosis* / Q000188:drug therapy
D005369:Filaricides; D004049:Diethylcarbamazine