A 50-year-old man from rural West Bengal with a long history of eating raw freshwater carp presents with recurrent right upper quadrant pain and jaundice. ERCP shows adult flat worms in the bile ducts. This infection is a well-established risk factor for which malignancy?
- A Cholangiocarcinoma ✓
- B Hepatocellular carcinoma
- C Gallbladder adenocarcinoma
- D Pancreatic ductal adenocarcinoma
Correct answer: A. Cholangiocarcinoma
Explanation
Clonorchis sinensis, the Chinese liver fluke, is acquired by eating raw freshwater fish containing metacercariae. The worms inhabit the intrahepatic bile ducts, where chronic mechanical irritation and inflammation predispose to adenomatous hyperplasia and cholangiocarcinoma. This association is listed as a Group 1 biological carcinogen. Chronic infection may cause recurrent pyogenic cholangitis, but hepatocellular carcinoma is linked to hepatitis B and C, not to liver flukes.
Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.