Hepatic lesions in an elderly woman - cancer isn't always the answer

Multiple hepatic lesions in an elderly woman usually suggest metastatic malignant disease, in most situations already beyond cure. However, we present the case of an 81-year-old female in whom histopathology verified granulomas and PCR proved hepatic tuberculosis. Tuberculostatic quadruple therapy resulted in complete remission. Isolated hepatic tuberculosis is rare, especially in HIV-negative subjects living in areas of low tuberculosis prevalence. This case highlights the need to histopathologically confirm malignancy as withholding therapy would have been deleterious in this curable patient.