Hepatic eosinophilic pseudotumor due to Fasciola hepatica infection mimicking intrahepatic cholangiocarcinoma: A case report

BACKGROUND Hepatic eosinophilic pseudotumor (HEPT) is a rare condition that mimics malignant hepatic tumors, posing significant diagnostic challenges. This case report highlights the importance of considering parasitic infections like Fasciola hepatica (F. hepatica) in the differential diagnosis of hepatic masses, especially in endemic regions, to prevent unnecessary interventions. CASE SUMMARY A 40-year-old female presented with a 1-month history of epigastric pain and significant weight loss. Imaging revealed a hepatic mass, initially misdiagnosed as intrahepatic cholangiocarcinoma. Laboratory results showed marked eosinophilia, and histopathological examination confirmed significant eosinophilic infiltration without malignancy. Serological testing identified F. hepatica infection. The patient was treated with a single dose of triclabendazole, leading to complete symptom resolution and normalization of hepatic imaging findings within days. CONCLUSION HEPT due to F. hepatica can closely mimic malignancy; timely antiparasitic treatment is crucial for resolution.