Crossroads of Infection- When a Liver Parasite Meets Liver Cancer: A Case Report and Literature Review

A BSTRACT Fasciolopsiasis, caused by Fasciolopsis buski (F. buski) , is a neglected tropical disease predominantly seen in Southeast Asia, where waterborne infections are common. Hepatocellular carcinoma (HCC), on the other hand, is a leading cause of cancer-related deaths worldwide. The co-occurrence of these two conditions is rare, posing significant diagnostic and management challenges. This report discusses the case of a 63-year-old male with underlying HCC who presented with complaints of persistent back pain, recurrent loose stools, and oral ulcers following a recent dental extraction. The ultrasound of the abdomen confirmed the presence of multiple hepatic lesions consistent with HCC and a mild amount of ascites, while his upper gastrointestinal endoscopy depicted the presence of a lower esophageal ulcer, gastrointestinal reflux disease, hiatus hernia, and antral gastritis. The routine stool microscopy showed the presence of the egg of F. buski . The narrative explores the clinical findings, diagnosis, and multidisciplinary approach used in managing this intriguing case.