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Schistosomiasis — SCE Infectious Diseases MCQ

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HardParasitologySchistosomiasisSCE Infectious Diseases

A migrant from an endemic region has terminal-spined Schistosoma eggs in urine and a bladder squamous-cell carcinoma. Which causal pathway is best supported?

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Correct answer: E — Chronic Schistosoma haematobium egg deposition causes granulomatous inflammation, squamous metaplasia and malignant transformation with review

The best answer is “Chronic Schistosoma haematobium egg deposition causes granulomatous inflammation, squamous metaplasia and malignant transformation with review”. Urinary S. haematobium, not intestinal S. mansoni, is the established carcinogenic exposure linked to bladder squamous-cell carcinoma. “Schistosoma mansoni directly invades urothelial nuclei and causes transitional-cell carcinoma” is less appropriate because it does not satisfy the scenario's decisive clinical or jurisdictional requirement. “Praziquantel exposure induces bladder dysplasia” is less appropriate because it does not satisfy the scenario's decisive clinical or jurisdictional requirement. “The parasite causes renal-cell carcinoma through haematogenous spread” is less appropriate because it does not satisfy the scenario's decisive clinical or jurisdictional requirement. “The association is explained entirely by coincidental smoking” is less appropriate because it does not satisfy the scenario's decisive clinical or jurisdictional requirement.

Reference: WHO schistosomiasis fact sheet: https://www.who.int/news-room/fact-sheets/detail/schistosomiasis