Toxocariasis of the liver: visceral larva migrans

Toxocariasis is caused by dog ascarid, Toxocara canis, forming eosinophilic inflammation such as eosinophilic abscess or granuloma in the liver and lungs. The lesions move slowly and thus the disease is called as visceral larva migrans. On CT or MR imaging, hepatic lesions are seen as multiple, ill-defined, oval lesions that measure 1.0–1.5 cm in diameter. Sometimes, the lesion may be angular or trapezoid. The lesions are usually best seen on the portal venous phase in dynamic contrast-enhanced CT and MR imaging; the lesions are either not seen or only faintly seen on arterial and equilibrium phases. Either an enhancing rim or enhancing nodules are sometimes observed. On sonography, the lesions appear as multiple, small, oval hypoechoic lesions in the liver parenchyma. The lesions differ from metastatic nodules is as much as they have fuzzy margins, are uniform in size, non-spherical shape and are best seen on portal venous phase. On follow-up imaging, the lesions may improve, or sometimes a change positions, reflecting migration of larva in the liver, supporting the phenomenon of visceral larva migrans.