title: An incidental case of biliary fascioliasis mimicking cholangiocellular carcinoma.
abstract: Fascioliasis is a zoonotic infestation caused by Fasciola hepatica that usually attacks mammals, such as goats, sheep and cattle. The parasites can infect humans via freshwater plants contaminated with encysted metacercariae. In the acute phase, which involves hepatic invasion, the disease may present with abdominal pain, mild fever and hepatomegaly. In the chronic phase, the parasites settle into the biliary tracts, and then cause cholangitis and cholestasis. Sometimes, the disease may mimic malignancies, creating a mass appearance. Endoscopic retrograde cholangiopancreatography (ERCP) is an important diagnostic and treatment method because it allows simultaneous diagnosis and treatment. Here, we present a 44-year-old female patient who presented to our hospital with complaints of abdominal pain, nausea, vomiting, anorexia and weight loss. After diagnostic investigations with laboratory and imaging methods, she was initially hospitalized with a preliminary diagnosis of cholangiocellular carcinoma (CCC). However, after a full work-up, the patient was diagnosed with Fasciola hepatica via ERCP and parasites were extracted with ERCP at the same time and then treated with a single dose of triclabendazole 10 mg/kg. Two months later, the clinical status of the patient had improved markedly, with resolution of all symptoms and all laboratory and imaging tests returning to within normal limits.
authors.affiliation: Dicle University Medical Faculty, Department of Gastroenterology; Dicle University Medical Faculty, Department of Internal Medicine; Diyarbakir Education and Research Hospital, Department of Internal Medicine; Dicle University Medical Faculty, Department of Infectious Diseases, Diyarbakir, Turkey.
authors.forename: Ebubekir
authors.initials: E
authors.lastname: Şenateş
authors.affiliation: Dicle University Medical Faculty, Department of Gastroenterology; Dicle University Medical Faculty, Department of Internal Medicine; Diyarbakir Education and Research Hospital, Department of Internal Medicine; Dicle University Medical Faculty, Department of Infectious Diseases, Diyarbakir, Turkey.
authors.forename: Abdullah
authors.initials: A
authors.lastname: Doğan
authors.affiliation: Dicle University Medical Faculty, Department of Gastroenterology; Dicle University Medical Faculty, Department of Internal Medicine; Diyarbakir Education and Research Hospital, Department of Internal Medicine; Dicle University Medical Faculty, Department of Infectious Diseases, Diyarbakir, Turkey.
authors.forename: Banu Erkalma
authors.initials: BE
authors.lastname: Şenates
authors.affiliation: Dicle University Medical Faculty, Department of Gastroenterology; Dicle University Medical Faculty, Department of Internal Medicine; Diyarbakir Education and Research Hospital, Department of Internal Medicine; Dicle University Medical Faculty, Department of Infectious Diseases, Diyarbakir, Turkey.
authors.forename: Erdal
authors.initials: E
authors.lastname: Bodakçi
authors.affiliation: Dicle University Medical Faculty, Department of Gastroenterology; Dicle University Medical Faculty, Department of Internal Medicine; Diyarbakir Education and Research Hospital, Department of Internal Medicine; Dicle University Medical Faculty, Department of Infectious Diseases, Diyarbakir, Turkey.
authors.forename: Muhammet
authors.initials: M
authors.lastname: Bekçibasi
mesh_terms: D000328:Adult; D000818:Animals; D000871:Anthelmintics / Q000627:therapeutic use; D001562:Benzimidazoles / Q000627:therapeutic use; D001650:Bile Duct Neoplasms / Q000175:diagnosis*; D018281:Cholangiocarcinoma / Q000175:diagnosis*; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000379:methods; D003937:Diagnosis, Differential; D005210:Fasciola hepatica / Q000302:isolation & purification*; D005211:Fascioliasis / Q000175:diagnosis* / Q000188:drug therapy / Q000469:parasitology; D005260:Female; D006801:Humans; D033162:Incidental Findings; D016896:Treatment Outcome; D000077682:Triclabendazole
chemical_list: D000871:Anthelmintics; D001562:Benzimidazoles; D000077682:Triclabendazole