title: Toxocariasis masquerading as liver and lung metastatic nodules in patents with gastrointestinal cancer: clinicopathologic study of five cases.
abstract: BACKGROUND
  There are sporadic reports in the literature in which radiologic liver and lung lesions found incidentally during follow-up metastatic surveillance were shown to be caused by toxocariasis.
  
  
  OBJECTIVE
  The objective of the work discussed in this report was to identify common clinical and histopathological features of toxocariasis resembling metastatic nodules in five patients with gastrointestinal cancer.
  
  
  METHODS
  We retrospectively analyzed clinical features of five gastrointestinal cancer patients with liver or lung nodules mimicking metastasis. Serologic tests for parasitic infestations and pathologic examinations were performed.
  
  
  RESULTS
  All five patients were males and three patients had gastric cancer and two had colorectal cancer. All the cases of toxocariasis were confirmed serologically. On follow-up imaging, the lesions improved or resolved, suggestive of the phenomenon of visceral larva migrans. In two patients, liver biopsy was performed and showed eosinophilic abscess.
  
  
  CONCLUSIONS
  Serologic tests and liver or lung biopsy should be performed aggressively to exclude toxocariasis when patients with underlying gastrointestinal cancer present with hepatic or pulmonary nodules associated with eosinophilia, particularly if the patients have a clinical history of raw animal liver ingestion. Curative surgical intervention should not be excluded just because of multiple nodules in the liver or the lungs.
authors.affiliation: Department of Pathology, Gachon University of Medicine and Science, 1198 Guwol-dong, Namdong-gu, Incheon 405-760, Korea. americandoc@gilhospital.com
authors.forename: Sanghui
authors.initials: S
authors.lastname: Park
authors.forename: Yun Soo
authors.initials: YS
authors.lastname: Kim
authors.forename: Yu Jin
authors.initials: YJ
authors.lastname: Kim
authors.forename: Sun Young
authors.initials: SY
authors.lastname: Kyung
authors.forename: Jeong-Woong
authors.initials: JW
authors.lastname: Park
authors.forename: Sung Hwan
authors.initials: SH
authors.lastname: Jeong
authors.forename: Sang Pyo
authors.initials: SP
authors.lastname: Lee
mesh_terms: D015766:Albendazole / Q000627:therapeutic use; D000818:Animals; D000871:Anthelmintics / Q000627:therapeutic use; D000909:Antibodies, Helminth / Q000097:blood; D001706:Biopsy; D015179:Colorectal Neoplasms / Q000473:pathology / Q000601:surgery; D003937:Diagnosis, Differential; D005770:Gastrointestinal Neoplasms / Q000473:pathology* / Q000601:surgery; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007816:Larva Migrans, Visceral / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D008099:Liver / Q000469:parasitology / Q000473:pathology; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000556:secondary*; D008168:Lung / Q000469:parasitology / Q000473:pathology; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000556:secondary*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012698:Serologic Tests; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery; D017166:Toxocara canis / Q000276:immunology / Q000302:isolation & purification
chemical_list: D000871:Anthelmintics; D000909:Antibodies, Helminth; D007074:Immunoglobulin G; D015766:Albendazole