Department of Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
Department of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
Sultan Qaboos Univ Med J. 2022 Aug;22(3):421-425. doi: 10.18295/squmj.6.2021.091. Epub 2022 Aug 25.
Spontaneous rupture of a metastatic liver tumour is rarely documented in the literature when compared to hepatocellular carcinoma and other liver lesions, especially from a lung primary. 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 patient presented to a tertiary care institute in 2020 with complaints of abdominal pain, breathlessness and fever. On examination, the patient was tachypnoeic 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.
与肝细胞癌和其他肝脏病变相比，转移性肝脏肿瘤的自发性破裂在文献中很少被记录，尤其是来自肺部原发性肿瘤的情况。我们报告了一例来自肺腺癌的破裂肝转移病例，其表现类似于破裂性肝脓肿，对临床诊断构成了挑战。一名 42 岁女性患者于 2020 年因腹痛、呼吸困难和发热就诊于一家三级保健机构。体格检查时，患者呼吸急促，右季肋部有肿块。腹部和胸部的增强 CT 显示肝脏内有一个边界不清的不均匀增强病变，伴有一个囊下连通性积液，左叶有低增强病变，左肺有不均匀增强病变。肺腺癌伴肝转移经芯针活检证实。患者接受了静脉内抗生素、肋间引流管和吉非替尼的保守治疗。然而，尽管尽了最大努力，患者还是死于该疾病。
