A Case of Combined Hepatocellular-cholangiocarcinoma Mimicking Pyogenic Liver Abscess.
- Author:
Seung Suk BAEK
1
;
Eileen L YOON
;
Hyun Jung KIM
;
Kyung Eun BAE
;
Kyeongmee PARK
;
Won choong CHOI
Author Information
- Publication Type:Case Report
- Keywords: Combined hepatocellular-cholangiocarcinoma; Liver abscess; Hepatocellular carcinoma
- MeSH: alpha-Fetoproteins; Biomarkers, Tumor; Carcinoma, Hepatocellular; Diagnosis; Hepatitis B, Chronic; Humans; Liver; Liver Abscess; Liver Abscess, Pyogenic*; Liver Neoplasms; Lymphatic Diseases; Male; Needles; Pathology
- From:Journal of Liver Cancer 2017;17(2):174-181
- CountryRepublic of Korea
- Language:Korean
- Abstract: Heterogeneous features of liver cancer can mimic liver abscess. Therefore it is essential to double-check tumor markers in the diagnosis of liver abscess. Herein, we report a case of combined hepatocellular-cholangiocarcinoma (cHC) occurred in an unrecognized chronic hepatitis B patient initially misdiagnosed as liver abscess. A 49-year old male initially presented with chill, right upper quadrant pain, and a liver mass. Mass showed peripheral enhancement in arterial phase of computed tomography, which was not typical for hepatocellular carcinoma (HCC). Strikingly elevated alpha-fetoprotein and fine needle aspirated pathology revealed HCC. Despite discordant image findings he was treated with transarterial chemoembolization. He was treated with sorafenib due to metastatic retrocaval lymphadenopathy afterwards. The mass presumed to be HCC progressed with sorafenib. It was surgically resected and he was finally confirmed as cHC. Discordant tumor markers with presumptive image findings should prompt the suspicion of rare type of primary liver cancer, the cHC.
