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Solitary necrotic nodule of the liver misinterpreted as malignant lesion: Considerations on two cases
Author(s) -
De Luca Maurizio,
Luigi Bucci,
Formisano Cesare,
Formato Antonio,
De Werra Carlo,
Cappuccio Mario,
Loffredo Andrea,
Forestieri Pietro
Publication year - 2000
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/1096-9098(200007)74:3<219::aid-jso13>3.0.co;2-q
Subject(s) - medicine , nodule (geology) , lesion , pathology , solitary pulmonary nodule , radiology , computed tomography , paleontology , biology
In our experience, we document 2 cases of a rare and non‐tumoral lesion of the liver misinterpreted as necrotic tumor: necrotic solitary nodule. In the first clinical case, ultrasound (US) showed a polylobated lesion (35 × 35 × 38 mm) at segment 8. Color‐doppler identified a compression of celiac axis (Dunbar syndrome). Arteriography revealed a subtotal stenosis of celiac tripod soon after the emergence of the left gastric artery. FNAB‐CT showed a highly cellulated tissue with a necrotic core surrounded by a fibersclerotic tissue. The patient underwent surgery: cholecystectomy and correction of Dunbar syndrome. US follow‐up showed a progressive reduction in diameter of the lesion (24 × 25 × 25 mm at 24 months), suggesting in this case the role of ischemic injury in the pathogenesis of the lesion. In the second clinical case, a hypoechoic lesion (32 × 32 × 30 mm) of segment 6 as occasional US finding during the staging for prostate cancer was shown. FNAC‐CT showed a positive result for necrotic cells. Surgical treatment consisted in a wide excision of the lesion. Histologically the lesion was solitary necrotic nodule. The diagnosis of this rare lesion is accidental. In accordance with the literature (50% of cases), we founded an associated tumor. Radiology doesn't differentiate solitary necrotic nodule and other solid lesions. Diagnosis is histological (in our second case, FNAC‐CT misinterpreted the tumor as a malignant lesion, while histology showed the real nature of it). J. Surg. Oncol. 2000;74:219–222. © 2000 Wiley‐Liss, Inc.