Hepatocellular carcinoma associated with liver abscess

Area of Science:

• Hepatology
• Oncology
• Infectious Diseases

Background:

• Hepatitis B and C are common in Taiwan, increasing risks of liver cirrhosis and hepatocellular carcinoma (HCC).
• Liver abscess co-occurring with HCC is an infrequent clinical scenario.
• Accurate differential diagnosis between HCC and liver abscess is crucial for effective patient management.

Purpose of the Study:

• To analyze the clinical characteristics, imaging findings, and outcomes of patients with HCC and coexisting liver abscess.
• To improve the diagnostic approach for this rare condition.

Main Methods:

• Retrospective review of medical records for nine HCC patients with liver abscess from January 2005 to July 2007.
• Analysis of clinical data, imaging studies (ultrasound, CT), laboratory results, and treatment strategies.
• Confirmation of HCC via cytology or pathology.

Main Results:

• All patients presented with fever and elevated alkaline phosphatase levels.
• Klebsiella pneumoniae was identified in all aspirate cultures.
• Imaging revealed liver tumors, with some showing lead-enhanced hypervascular areas.
• Treatment modalities included antibiotics, transhepatic arterial chemoembolization, and surgery.

Conclusions:

• Focal liver inflammation can mimic solid tumors, making HCC with abscess difficult to diagnose.
• Aspiration cytology or pathology is essential for definitive diagnosis.
• Early recognition and appropriate management are vital for improving outcomes in these rare cases.