Liver abscess as a atypical presentation of hepatocellular carcinoma

We present the case of a 64-year-old male with a history of chronic liver disease due to hepatitis C virus, with a sustained viral response after oral antiviral treatment and without follow-up for 5 years. He was admitted after a one-month history of constitutional symptoms, low-grade fever, abdominal pain and a palpable epigastric tumor. Analysis showed marked elevation of acute phase reactants (48,000 leukocytes and C-reactive protein of 19mg/dl) and dissociated cholestasis. Two lesions were identified by abdominal CT.