CASE 147: LIVER TUMOR MIMICKING HEPATIC ABSCESS , Dr PHAN THANH HẢI, MEDIC MEDICAL CENTER, HCMC, VIETNAM

MAN 35 YO, PAIN AT RIGHT SUBCOSTAL AREA, CLINICAL POSITIVE MURPHY'S SIGN.

ULTRASOUND DETECTED  A FOCAL LESION NEARBY GALLBLADDER, SIZE OF 4,9 CM, HYPOECHOIC  WITH CENTRAL WHITE SPOT, THEN SUSPECTED LIVER ABSCESS.

MSCT OF LIVER WITH CE ALSO SUGGESTED A LIVER ABSCESS.

Blood tests  showed that patient infected HBV with AFP L3  high risk.

Laparotomy was done for resection the liver tumor and gallbladder.

In macroscopy, it is an invasion to gallbladder of a very hard liver tumor.



MICROSCOPIC REPORT IS  LIVER CANCER .

 

 

 

BUT SOME QUESTIONS: IN THIS CASE, WHY   THE CENTRAL PART OF TUMOR  IS VERY HYPODENSE ON  CT  SCAN WHILE ITS  VERY  HYPERECHOIC ON  ULTRASOUND, AND IN COMPARISON TO THE MACROSCOPIC SPECIMEN,   AND WHAT IS THE REASON ?