Open AccessA case of leptospirosis simulating colon cancer with liver metastases
Author(s) -
Alessandro Granito,
G. Ballardini,
M. Fusconi,
Umberto Volta,
Paolo Muratori,
Vittorio Sambri,
Giuseppe Battista,
Francesco Bianchi
Publication year - 2004
Publication title -
world journal of gastroenterology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.427
H-Index - 155
eISSN - 2219-2840
pISSN - 1007-9327
DOI - 10.3748/wjg.v10.i16.2455
Subject(s) - medicine , colorectal cancer , colonoscopy , malignancy , gastroenterology , alkaline phosphatase , leptospirosis , pathology , abdomen , elevated alkaline phosphatase , cancer , radiology , biology , biochemistry , enzyme
We report a case of a 61-year-old man who presented with fatigue, abdominal pain and hepatomegaly. Computed tomography (CT) of the abdomen showed hepatomegaly and multiple hepatic lesions highly suggestive of metastatic diseases. Due to the endoscopic finding of colon ulcer, colon cancer with liver metastases was suspected. Biochemically a slight increase of transaminases, alkaline phosphatase and gammaglutamyl transpeptidase were present; alpha-fetoprotein, carcinoembryogenic antigen and carbohydrate 19-9 antigen serum levels were normal. Laboratory and instrumental investigations, including colon and liver biopsies revealed no signs of malignancy. In the light of spontaneous improvement of symptoms and CT findings, his personal history was reevaluated revealing direct contact with pigs and their tissues. Diagnosis of leptospirosis was considered and confirmed by detection of an elevated titer of antibodies to leptospira. After two mo, biochemical data, CT and colonoscopy were totally normal.