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This dispatch reports four cases of pancreatic schistosomiasis from endemic regions in China between 2020 and 2024, highlighting the diagnostic challenge when pancreatic lesions mimic malignancy. The cases include imaging, endoscopic ultrasound-guided fine-needle aspiration findings with schistosome eggs, stool detection of S. japonicum, and treatment with praziquantel followed by symptom resolution or operative management.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/pancreatic-schistosomiasis-china-2020-2024-dispatches-case-series/458896/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/pancreatic-schistosomiasis-china-2020-2024-dispatches-case-series/458896.png","ImageObject",300,407,{"name":92,"@type":93},"Indoniesian Boy","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-07","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":14},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Why is pancreatic schistosomiasis difficult to diagnose?","Question",{"text":112,"@type":113},"Pancreatic involvement is exceedingly rare, and pancreatic lesions can resemble other conditions, including pancreatic malignancy. The article underscores the diagnostic challenge through the reported cases and their imaging and pathology findings.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What diagnostic tests confirm pancreatic schistosomiasis in the cases?",{"text":117,"@type":113},"Diagnosis is supported by pathology from endoscopic ultrasound-guided fine-needle aspiration showing schistosome eggs, along with stool testing detecting Schistosoma eggs in the reported patients.",{"name":119,"@type":110,"acceptedAnswer":120},"How are the patients treated and what outcomes are reported?",{"text":121,"@type":113},"Patients received praziquantel (described as a 1-day course in the dispatch), and symptom resolution is reported after treatment in at least one case. In another case, management included laparoscopic distal pancreatectomy based on suspected alternative diagnoses.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},458896,1790754713,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":14,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":19,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":129,"read_time":52,"preview_page_count":4},962090760608,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","DISPATCHES  \nPancreatic Schistosomiasis, China, 2020–2024  \nLong He,1 Chuanbing Zhao,1 Yu Lu,1 Hongzhen Wei, Zanglong Deng, Yunpeng Zhang, Tao Yin  \nSchistosomiasis is a globally prevalent parasitic infection, but pancreatic involvement is extremely rare. In this article, we report 4 cases of pancreatic schistosomiasis from endemic regions in China. The possible link between schistosomiasis and pancreatic malignancy deserves further study. These cases underscore the diagnostic challenge of pancreatic schistosomiasis.  \nSctistosmatoomdeiasiss oftishe agparenuassiticSchisitnoectiomao)cauGlsoedbalbyly,≈1 billion people are at risk for schistosomiasis and there have been 250 million cases across 78 countries. By 2021, the disease accounted for >1.8 million disability-adjusted life years lost. Schistosoma infection is closely linked to impoverished living conditions (2) .  \nThe Schistosoma lifecycle requires an intermediate host, such as Biomphalaria, Bulinus, and Oncomelania snails, before infecting and causing disease in definitive hosts such as humans or other mammals (3) . The main pathogenic species in humans are S. hematobium, S. japonicum, and S. mansoni. Although adult worms are relatively nonpathogenic, their eggs induce granulomatous inflammation characterized byeosinophilic and lymphocytic infiltration, leading to both acute and chronic disease (4) .  \nThe clinical manifestations of schistosomiasis are related to infection intensity and duration, and the intestines, liver, and bladder are the most involved organs (2). Early infection might manifest as cercarial dermatitis. Acute schistosomiasis is often asymptomatic, but sudden onset of fever, myalgia, fatigue, and abdominal pain lasting 2–10 weeks can occur. Chronic schistosomiasis is typically characterized by nonspecific, intermittent abdominal pain, diarrhea, and rectal bleeding (in S. mansoni and S. japonicum infections) or hematuria (in S. hematobium infection). In advanced chronic cases,  \nAuthor affiliation: Union Hospital Department of Pancreatic Surgery, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China  \nDOI: [https://doi.org/10.3201/eid3112.251098](https://doi.org/10.3201/eid3112.251098)  \ncomplications such as portal hypertension (S. mansoni and S. japonicum) or hydronephrosis, renal failure, and bladder cancer (S. hematobium) can occur (2).  \nEmerging evidence suggests that schistosomiasis is a systemic disease that might also involve the spleen, heart, lungs, nervous system, and other organs (5–7) . However, pancreatic involvement is exceedingly rare. In this article, we report 4 cases of schistosomiasis in China affecting the pancreas (Table) . Informed consent was obtained from the patients for the publication of their information.  \nThe Study  \nPatient 1 was a 49-year-old woman with a 1-year history of intermittent fever (up to 40°C) who was found to have a space-occupying lesion in the pancreatic head during routine examination in October 2020. She resided in Hubei, China, and had a history of untreated schistosomiasis. Computed tomography at Wuhan Union hospital revealed a 4.8 × 3.5 cm mass superior to the pancreatic head, involving the pancreas and associated with enlarged peripancreatic lymph nodes (Figure 1, panels A, B) . Tumor markers were unremarkable, but hemoglobin was mildly reduced (93 g/L, reference range 115–150 g/L) . To clarify the diagnosis, we conducted an endoscopic ultrasound-guided fine-needle aspiration of the pancreatic head. Pathology demonstrated fibrinous exudate and schistosome eggs (Figure 1, panel C). S. japonicum eggs were also found in the stool. The patient was diagnosed with pancreatic schistosomiasis and treated with a 1-day course of praziquantel (60 mg/kg in 3 doses) . Two weeks later, her symptoms resolved, and she was discharged. No fever recurrence was observed at 3-month follow-up.  \nPatient 2 was a 73-year-old man who sought care in November 2024 with 1 day of abdominal pain. Six","cbCaikuJuQMiOZhW","https://ap.wps.com/l/cbCaikuJuQMiOZhW","pdf",1641896,"English","# Background\n## Global burden and lifecycle\n## Clinical manifestations and complications\n# Study Design and Cases\n## Patient 1\n## Patient 2\n## Patient 3\n## Patient 4\n# Imaging and Diagnostic Findings\n## CT and endoscopic ultrasound\n## Pathology and stool testing\n# Treatment and Outcomes","[{\"question\":\"Why is pancreatic schistosomiasis difficult to diagnose?\",\"answer\":\"Pancreatic involvement is exceedingly rare, and pancreatic lesions can resemble other conditions, including pancreatic malignancy. The article underscores the diagnostic challenge through the reported cases and their imaging and pathology findings.\"},{\"question\":\"What diagnostic tests confirm pancreatic schistosomiasis in the cases?\",\"answer\":\"Diagnosis is supported by pathology from endoscopic ultrasound-guided fine-needle aspiration showing schistosome eggs, along with stool testing detecting Schistosoma eggs in the reported patients.\"},{\"question\":\"How are the patients treated and what outcomes are reported?\",\"answer\":\"Patients received praziquantel (described as a 1-day course in the dispatch), and symptom resolution is reported after treatment in at least one case. In another case, management included laparoscopic distal pancreatectomy based on suspected alternative diagnoses.\"}]","Pancreatic Schistosomiasis, China, 2020-2024 - Dispatches - Case series | PDF"]