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Clin Infect Dis 1998 May;26(5):1224-1226
Hepatocellular carcinoma presenting as pyogenic liver abscess:
characteristics, diagnosis, and management.
Yeh TS, Jan YY, Jeng LB, Chen TC, Hwang TL, Chen MF
Department of Surgery and Pathology, Chang-Gung Memorial Hospital, Chang-Gung
University, Taipei, Taiwan.
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).
PMID: 9597257, UI: 98259545
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