A Case of Fascioliasis Diagnosed as Preoperative Metastatic Liver Tumor Successfully Treated with Microwave Coagulation Therapy

Noriyuki Hirahara, Sinzi Iwasaki^*, Hiroaki Watanabe and Yoshinori Nio^*

Department of Surgery, Tsuwano Kyozon Hospital^* First Department of Surgery, Shimane Medical University

A 46-year-old woman was hospitalized for an elastic hard and ill-defined tumor about 2 cm in diameter palpated in the C area of the left breast. The leukocyte count was normal, but there was a slight increase in eosinophils of 17% and liver dysfunction was recognized. Ultrasonography showed a 3.5×2.5cm low echogenecitic tumor in the right liver lobe and plain computed tomography (CT) showed a low density area. Feridex magnetic resonance imaging (MRI) showed high signal intensity. Angiography revealed an unclear tumor stain, and CT during arterialportography (CTAP) showed portal blood flow to be decreased. Mastectomy and microwave coagulationtherapy (MCT) were conducted under a diagnosis of left breast cancer and metastatic liver cancer. Parasitic infection of the liver was suspected due to the invasion of advanced eosinophils in the liver biopsy specimen and fascioliasis diagnosed from the serum immunological test. Fascioliasis is usually treated by administering Praziquantel. Postoperative normalized liver function and eosinophils and no recurrence in the 2 years indicated that cure was effected completely by MCT.

Key words
metastatic liver tumor, fascioliasis, microwave coagulationtherapy

Reprint requests
Noriyuki Hirahara Department of Surgery, Tsuwano Kyozon Hospital Ro 141 Oaza Morimura, Tsuwanocyo, Kanoashigun, Shimane, 699-5604 JAPAN

Accepted
July 30, 2001

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