Fantastic flukes and where to find them

We describe the case of a middle-aged Chinese migrant with background metastatic hepatocellular carcinoma (HCC) who was found to have parasitic perihepatic fluid collection masquerading as malignant collection. The aspirate this showed no organisms on gram stain negative cultures. A smear and cell block for cytology moderate bile, debris, proteinaceous material occasional macrophages. No cells were seen, however few clustered single egg like structures noted suggestive eggs liver fluke. size appearance these opercula typical shoulders Clonorchis or Opisthorchis spp. ova, cysts parasites examination stool. Treatment weight based oral praziquantel prescribed two days. Due advanced malignancy provided minimal relief focus his care shifted pain management. This patient’s Hepatitis B serology over recent years suggested that he had distant resolved infection, repeatedly surface antigen testing. With biopsy proven diagnosis HCC, it is therefore interesting postulate inflammatory carcinogenic potential flukes beyond its association cholangiocarcinoma.