Open AccessThe Diagnostic Dilemma of Ruptured Liver Metastasis in a Patient with Lung Cancer
Author(s) -
Kalkunte Sriram Jayanth,
Madan Shivakumar,
Balakrishnan Gurushankari,
Sathasivam Sureshkumar,
Amaranathan Anandhi,
Rajesh Ng,
Vikram Kate
Publication year - 2022
Publication title -
sultan qaboos university medical journal
Language(s) - English
Resource type - Journals
eISSN - 2075-0528
pISSN - 2075-051X
DOI - 10.18295/squmj.6.2021.091
Subject(s) - medicine , radiology , lung , metastasis , adenocarcinoma , lung cancer , abdomen , liver abscess , hepatocellular carcinoma , thorax (insect anatomy) , gefitinib , abdominal pain , cancer , pathology , abscess , surgery , anatomy , epidermal growth factor receptor
Spontaneous rupture of a metastatic liver tumour is rarely documented in literature when compared to hepatocellular carcinoma and other liver lesions, especially from a lung primary. Here we report a case of ruptured liver metastasis from an adenocarcinoma of the lung mimicking ruptured liver abscess, challenging the clinical diagnosis. A 42-year-female presented in July 2020 with complaints of abdominal pain, breathlessness, fever. On examination, the patient was tachypneic with a right hypochondriac mass. A contrast-enhanced computed tomography of abdomen and thorax revealed an ill-defined heterogeneously enhancing lesion in the liver with a communicating subcapsular collection and hypo enhancing lesions in the left lobe and heterogeneously enhancing lesion in the left lung. Adenocarcinoma of the lung with hepatic metastasis was confirmed with a core needle biopsy. The patient was managed conservatively with intravenous antibiotics, intercostal drainage tube and Gefitinib. However, despite best efforts, the patient succumbed to the disease.
Keywords: Liver secondaries; Spontaneous rupture; Hepatocellular carcinoma; Thyroid transcription factor; Liver abscess.