- A Case of Combined Hepatocellular-cholangiocarcinoma Mimicking Pyogenic Liver Abscess
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Seung Suk Baek, Eileen L. Yoon, Hyun-Jung Kim, Kyung Eun Bae, Kyeongmee Park, Won-choong Choi
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J Liver Cancer. 2017;17(2):174-181. Published online September 30, 2017
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DOI: https://doi.org/10.17998/jlc.17.2.174
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Abstract
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- Heterogeneous features of liver cancer can mimic liver abscess. Therefore it is essential to doublecheck
tumor markers in the diagnosis of liver abscess. Herein, we report a case of combined
hepatocellular-cholangiocarcinoma (cHC) occurred in an unrecognized chronic hepatitis B patient
initially misdiagnosed as liver abscess. A 49-year old male initially presented with chill, right
upper quadrant pain, and a liver mass. Mass showed peripheral enhancement in arterial phase
of computed tomography, which was not typical for hepatocellular carcinoma (HCC). Strikingly
elevated alpha-fetoprotein and fine needle aspirated pathology revealed HCC. Despite discordant
image findings he was treated with transarterial chemoembolization. He was treated with
sorafenib due to metastatic retrocaval lymphadenopathy afterwards. The mass presumed to be
HCC progressed with sorafenib. It was surgically resected and he was finally confirmed as cHC.
Discordant tumor markers with presumptive image findings should prompt the suspicion of rare
type of primary liver cancer, the cHC.
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