A 52-year-old man from Manipur who regularly eats raw freshwater fish presents with recurrent episodes of right upper quadrant pain and cholangitis. Stool examination shows small operculated eggs. Long-standing infection with the responsible fluke is best known for predisposing to which malignancy?
- A Cholangiocarcinoma ✓
- B Hepatocellular carcinoma
- C Transitional cell carcinoma of the bladder
- D Colorectal adenocarcinoma
Correct answer: A. Cholangiocarcinoma
Explanation
Clonorchis sinensis (and Opisthorchis species) inhabit the biliary tree after ingestion of metacercariae in undercooked freshwater fish. Chronic inflammation and ductal epithelial hyperplasia are strongly associated with cholangiocarcinoma, an established IARC Group 1 biological carcinogen. Hepatocellular carcinoma is linked to hepatitis A and C, bladder transitional cell carcinoma to Schistosoma haematobium, and colorectal cancer has no helminthic association.
Reference: Paniker's Textbook of Medical Parasitology, 9th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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