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EURO EUS MEETING
Year : 2014  |  Volume : 3  |  Issue : 5  |  Page : 11-12

Liver abscess as a first manifestation of colonic tumor


1 Hospital me de deus, Porto Alegre, Brazil
2 Hospital Moinhos de Vento, Porto Alegre, Brazil

Date of Web Publication27-Mar-2014

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Source of Support: None, Conflict of Interest: None


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How to cite this article:
Schneider N C, Coelho N, Dutra P, Dalmolin R, Dincao R, Appel M. Liver abscess as a first manifestation of colonic tumor. Endosc Ultrasound 2014;3, Suppl S1:11-2

How to cite this URL:
Schneider N C, Coelho N, Dutra P, Dalmolin R, Dincao R, Appel M. Liver abscess as a first manifestation of colonic tumor. Endosc Ultrasound [serial online] 2014 [cited 2020 Jan 27];3, Suppl S1:11-2. Available from: http://www.eusjournal.com/text.asp?2014/3/5/11/129515

Introduction: Male, 72-year-old, morbidly obese, diabetic, admitted for abdominal pain, prostration and fever that started last 3 days. Abdominal ultrasound and abdominal computed tomography scan showed liver injury in the transition of V and VI segments measuring 8.4 cm. Due to the possibility of liver abscess, initiate empirical antibiotic therapy with ampicillin and sulbactam and metronidazole and performed ultrasound-guided percutaneous drainage of liver injury. Negative for malignant cells, with the presence of leukocytes and negative culture. After 2 weeks of treatment, take control image without changing the lesion dimension. New percutaneous drainage with the same results. We opted for performing endoscopic ultrasound (EUS) with fine-needle aspiration (FNA). FNA pathology: Moderately differentiated adenocarcinoma. Immunohistochemistry suggestive of metastasis of the lower gastrointestinal tract. Due this finding, realized colonoscopy, which revealed a vegetating lesion with central ulceration, bleeding, filling almost the entire cecum. Patient was referred for surgical resection of the bowel tumor, which showed moderately differentiated adenocarcinoma infiltrating vegetative and possibly originated from villous adenoma with high-grade dysplasia.

Discussion: The finding of metastatic liver abscess of colonic neoplasia is not common. In most cases, the material from the abscess drainage allows the diagnosis, but in this case, even after two ultrasound-guided percutaneous drainage was not obtained conclusive bacteriological or histopathological. Opted for new puncture through EUS, which allowed definitive diagnosis of the condition.

Conclusion: Metastatic colon neoplasm should be considered in cases of differential diagnosis of liver abscess.

Status of the presenting author: Chief resident

The authors declare: No significant relationship.




 

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