Eosinophilic abscesses: a new facet of hepatic visceral larva migrans

Hepatic visceral larva migrans (VLM) refers to a condition characterized by granulomatous liver lesions containing eosinophils and inflammatory cells associated with migration of second-stage larvae of certain nematodes such as toxocara canis. The typical imaging findings described in the literature include small, ill-defined, oval or elongated, low-attenuating nodules with fuzzy margins, non-spherical shape, and absent or insignificant rim enhancement on contrast-enhanced CT scan. The present series in contrast depicts a new imaging manifestation of hepatic VLM presenting as confluent and clustered complex cystic liver lesions. Pre-treatment imaging studies including contrast-enhanced CT/MRI of three patients are presented. One of the patients underwent liver resection while post-treatment follow-up scan at 6 months in the remaining two displayed regression of the lesions with antihelminthic treatment.