Hepatic pinworm infestation misdiagnosed as a liver metastasis in a patient with colonic adenocarcinoma

Dea Natalie Munch Jepsen; Jens Thomas Fredrik Osterkamp; Jakob Hagen Vasehus Schou; Peter Nørgaard Larsen; Rajendra Singh Garbyal

doi:10.1016/j.idcr.2020.e00803

Hepatic pinworm infestation misdiagnosed as a liver metastasis in a patient with colonic adenocarcinoma

IDCases. 2020 May 11:21:e00803. doi: 10.1016/j.idcr.2020.e00803. eCollection 2020.

Authors

Dea Natalie Munch Jepsen¹, Jens Thomas Fredrik Osterkamp², Jakob Hagen Vasehus Schou³, Peter Nørgaard Larsen², Rajendra Singh Garbyal¹

Affiliations

¹ Department of Pathology, University Hospital of Copenhagen, Rigshospitalet, Inge Lehmanns Vej 14, 2100 Copenhagen, Denmark.
² Department of Surgical Gastroenterology and Transplantation, University Hospital of Copenhagen, Rigshospitalet, Inge Lehmanns Vej 7, 2100 Copenhagen, Denmark.
³ Department of Oncology, University Hospital of Copenhagen, Herlev Hospital, Borgmester Ib Juuls Vej 7, 2730 Herlev, Denmark.

Abstract

An extra-intestinal infestation of Enterobius vermicularis (pinworm) is uncommon. We present a case of hepatic infestation of pinworm in a 57-year-old woman, misdiagnosed as a colorectal adenocarcinoma metastasis. The route of migration from the intestine to the liver is not well established but the most plausible route seems to be hematogenous. In concordance with previously published cases, the hepatic pinworm infestation is usually localised superficially in the right liver lobe. Hence solitary lesions in this location detected radiologically should be interpreted carefully. Additionally, the serum CEA level could be useful to distinguish pinworm from malignancy.

Keywords: Adenocarcinoma; Colon; Enterobius vermicularis; Liver metastasis; Misdiagnosis.

Publication types

Case Reports