Journal Article

Hepatocellular Carcinoma Presenting as Pyogenic Liver Abscess: Characteristics, Diagnosis, and Management

Ta-Sen Yeh, Yi-Yin Jan, Long-Bin Jeng, Tse-Ching Chen, Tsang-Long Hwang and Miin-Fu Chen

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 26, issue 5, pages 1224-1226
Published in print May 1998 | ISSN: 1058-4838
Published online May 1998 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/520290
Hepatocellular Carcinoma Presenting as Pyogenic Liver Abscess: Characteristics, Diagnosis, and Management

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We performed a 17-year retrospective analysis of 10 cases of hepatocellular carcinoma presenting as pyogenic liver abscess. Spontaneous tumor necrosis and biliary obstruction caused by tumor thrombi, superimposed with bacterial infection, were the two major pathogeneses. Exact diagnosis of the underlying hepatocellular carcinoma was made for five of the 10 patients before management was attempted. Main clinical manifestations included fever, chills, right-upper-quadrant pain, malaise, anorexia, jaundice, and hepatomegaly. Characteristics such as middle age and male sex, seropositivity for hepatitis B and/or hepatitis C, chronic liver disease, unexplained anemia, marked weight loss, and a severely inversed albumin/globulin ratio raise suspicions about the underlying hepatocellular carcinoma. Management strategies included percutaneous drainage (n = 3), surgical drainage (n = 4), and hepatectomy (n = 3) in addition to administration of parenteral antibiotics in all cases. The prognosis was dismal, with a mean survival of 3.5 months (range, 8 days to 6 months).

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Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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