SHM Converge Scientific Abstract ePoster Gallery-The Unexpected Helminth: Carcinogenic Potential of Schistosoma Mansoni

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This poster presents a case highlighting the possible carcinogenic potential of <em>Schistosoma mansoni</em>. Schistosomiasis is acquired through freshwater exposure to infected snails, and the larvae penetrate the skin, causing chronic granulomatous inflammation that can lead to long-term tissue damage. While <em>Schistosoma haematobium</em> is a well-established risk factor for bladder cancer, the link between <em>S. mansoni</em> and malignancy is much less certain and has mostly been described in case reports.

The case involves a 48-year-old active-duty man with a history of deployment to West Africa and prior residence in Cameroon. He presented with fever and abdominal pain that progressed to the right lower quadrant. Initial CT imaging showed right colon thickening with concern for contained perforation, and he improved with IV antibiotics. A repeat CT then showed an irregular cecal mass suspicious for malignancy, leading to a right hemicolectomy. Surgery revealed diffuse large B-cell lymphoma (DLBCL) involving the cecum, and adjacent colon mucosa contained eosinophilic granulomas with <em>Schistosoma mansoni</em> ova and organisms.

The patient was treated with praziquantel before starting chemotherapy. He also received ivermectin because of the risk of co-infection with <em>Strongyloides stercoralis</em>, which can cause life-threatening hyperinfection syndrome during immunosuppression. He then began DA-EPOCH-R plus ibrutinib for stage IV DLBCL.

The authors conclude that early treatment of <em>S. mansoni</em> is important to prevent long-term sequelae, and that further research is needed to clarify any cancer-causing role. The case also emphasizes screening and treatment for co-infections before chemotherapy.

Asset Subtitle

Sarah Schulte

Meta Tag

Author List Benjamin Rosen, James Nguyen, Joseph Roswarski, Kevin Pak, Sarah Schulte, Zachary Junga

Category Clinical Vignettes

Concept Schistosoma mansoni

Concept Schistosomiasis

Concept Diffuse Large B-Cell Lymphoma

Concept Strongyloides stercoralis

Concept Hyperinfection syndrome

Distinguished Non-Finalist

Presenter Organization Naval Medical Center Portsmouth

Presenting Author Sarah Schulte

Track Adult

Keywords

Schistosoma mansoni

schistosomiasis

diffuse large B-cell lymphoma

cecal mass

granulomatous inflammation

praziquantel

ivermectin

Strongyloides stercoralis

chemotherapy

West Africa

Schistosoma mansoni

Schistosomiasis

Diffuse Large B-Cell Lymphoma

Strongyloides stercoralis

Hyperinfection syndrome