Abstract
This is a case report of fascioliasis in the pancreas definitively diagnosed by a resected specimen. Preoperatively the fascioliasis had been diagnosed by endoscopic retrograde pancreatography (ERP) as cystadenocarcinoma of the pancreas. A 72-year-old man was admitted with persistent upper abdominal pain.A bdominal ultrasonography and computed tomography (CT) scan showed a space-occupying lesion in the pancreatic body. ERP disclosed a cystic mass in the pancreatic body, which was tentatively diagnosed as cystadenocarcinoma of the pancreas. Resection of the pancreatic body and tail, and total gastrectomy were performed. The lesion was found by microscopic examination of the resected specimen to be inflammatory granuloma with many parasite eggs and infiltrated eosinophils and lymphocytes. The size and shape of parasite eggs identified them as those of Fasciola hepatica. Identified the eggs and a skin test with F. hepatica antigen positively, specific positive reaction of an Ouchterlony test and immunoelectrophoresis indicated the infection was F. hepaica. From these 5 findings, this case was definitely diagnosed as F. hepatica ectopic parasitism in the pancreas.
