Liver tuberculoma

Liver tuberculosis is a fairly rare manifestation of extra-pulmonary tuberculosis. We distinguish several forms of liver affection by tuberculosis. One of these is liver tuberculoma, the incidence of which is quite rare. The authors present a case of liver tuberculoma as an occupational disease.

A 63-year-old veterinary doctor, who was diagnosed through a polymerase chain reaction with liver tuberculosis, was treated unsuccessfully with anti-tuberculosis drugs for a period of 8 months. After an earlier relapse of the focus in the liver it grew again and created an abscess (80 x 65 x 80 mm), together with a second satellite focus (20 mm). The patient was therefore indicated for a resection of 3 segments of the right liver lobe. The resection was without complications. The polymerase chain reaction, together with histology, proved the presence of a mycobacterium tuberculosis complex. Three year after the surgery, the patient is completely recovered, without any manifestations of the disease.

Liver resection for liver tuberculoma is indicated in case of progression of the finding and long-term unsuccessful treatment with anti-tuberculosis drugs. It is a safe method with very good long-term results (Fig. 2, Ref. 12).