Fascioliasis simulating an intrahepatic cholangiocarcinoma—Case report with imaging and pathology correlation

Human fascioliasis is a rare zoonosis in Chile. Clinically it presents with a highly polymorphousgroup of symptoms that evolve in two periods. The first, acute or a result of hepatic invasion, lasts 2 weeks to4 months and is characterized essentially by pain in the right hypochondrium and/or epigastrium, continuousfever and painful hepatomegaly. This clinical picture, associated with eosinophilia and a history of rawwatercress consumption, corresponds to the classic presentation of the disease in its initial stage. We reportthe case of a 57-year-old female patient with no risk factors for and no clinical signs of fascioliasis, with alesion in the right hepatic lobe compatible with intrahepatic cholangiocarcinoma, studied with computedtomography (CT), magnetic resonance imaging (MRI) and positron emission tomography (PET-CT). Withthe clinical suspicion of intrahepatic cholangiocarcinoma, a regulated right hepatectomy was performed, thepathological study of which revealed cholangitis and granulomatous pericholangitis resulting from trematodeeggs, compatible with Fasciola hepatica.