Hepatocellular Carcinoma Associated with Liver Abscess

Ching-I Huang ； Liang-Yen Wang ； Ming-Lun Yeh ； Ming-Yen Hsieh ； Jee-Fu Huang ； Zu-Yau Lin ； Wan-Long Chuang

《The Kaohsiung Journal of Medical Sciences》 25卷10期 (2009/10) Pp. 537-543

並列摘要

Hepatitis B and hepatitis C are highly prevalent in Taiwan. Chronic hepatitis patients are at high risk of progression to liver cirrhosis and hepatocellular carcinoma (HCC). However, HCC in association with liver abscess is very rare. Accordingly, this study analyzed the characteristics of HCC patients with liver abscess to improve the differential diagnosis of this condition. From January 2005 to July 2007, the medical records of nine HCC patients (4 females, 5 males; mean age, 65.8 years) treated for abscess formation at Kaohsiung Medical University Hospital were retrospectively reviewed. Their clinical characteristics, images, management approaches and outcomes were analyzed. Fever and highly elevated alkaline phosphatase levels were noted in all patients. All aspirate cultures revealed Klebsiella pneumoniae. All of the cases of HCC were confirmed by cytology or pathology. The imaging studies, which included abdominal ultrasonography and computed tomography, revealed liver tumors in all patients. In some cases, lead-enhanced hypervascular areas were noted. The patients were treated with antibiotic therapy, transhepatic arterial chemoembolization, or surgery. The findings of this study indicate that focal liver inflammatory changes may mimic solid neoplasms. Differential diagnosis of HCC with abscess is extremely difficult and may require aspiration cytology or pathology.

並列關鍵字

abdominal sonography ； computed tomography ； hepatocellular carcinoma ； liver abscess ； magnetic resonance imaging