Bladder and Liver Involvement of Visceral Larva Migrans May Mimic Malignancy
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Visceral larva migrans (VLM) syndrome is a clinical manifestation of systemic organinvolvement by Toxocara species. VLM with involvement of the bladder and liver is arare finding. A 62-year-old woman presented with diffuse bladder wall thickening andmultiple liver masses with peripheral eosinophilia and urinary symptoms. Weconsidered malignancy or eosinophilic cystitis through clinical manifestations andimaging findings. However, no suspicious malignant lesions were observed oncystoscopy and liver mass biopsy revealed the presence of eosinophilic necrotizinggranuloma without malignant cells. Anti-Toxocara antibodies were detected bywestern blotting and the patient was diagnosed with VLM syndrome. After takingprednisolone, urinary symptoms disappeared. On abdominal computed tomographyscan taken after three months, the size of multiple liver masses and bladder wallthickening had decreased. VLM syndrome should be suspected in patients with anatypical imaging pattern and peripheral eosinophilia.
Abstract
Visceral larva migrans (VLM) syndrome is a clinical manifestation of systemic organinvolvement by Toxocara species. VLM with involvement of the bladder and liver is arare finding. A 62-year-old woman presented with diffuse bladder wall thickening andmultiple liver masses with peripheral eosinophilia and urinary symptoms. Weconsidered malignancy or eosinophilic cystitis through clinical manifestations andimaging findings. However, no suspicious malignant lesions were observed oncystoscopy and liver mass biopsy revealed the presence of eosinophilic necrotizinggranuloma without malignant cells. Anti-Toxocara antibodies were detected bywestern blotting and the patient was diagnosed with VLM syndrome. After takingprednisolone, urinary symptoms disappeared. On abdominal computed tomographyscan taken after three months, the size of multiple liver masses and bladder wallthickening had decreased. VLM syndrome should be suspected in patients with anatypical imaging pattern and peripheral eosinophilia.
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