Nodular Hepatic Tuberculosis Masquerading as a Seminoma Liver Metastasis

Arch Iran Med. 2018 Apr 1;21(4):180-182.

Abstract

Isolated macro-nodular liver tuberculosis is a very rare condition. It may mimic primitive or secondary tumors of the liver. This could delay or mislead the therapeutic management. An immunocompetent 48-year-old man with a history of non-metastatic seminoma was treated with right orchidectomy followed by 20 Gy radiotherapy. The discovery, 8 months later, of a 2 cm nodule of the hepatic dome evoked a liver metastasis. Percutaneous biopsy was not feasible. Wedge resection was performed whereas medical treatment would have sufficed, as pathologic examination of the resected specimen showed a macro-nodular hepatic tuberculosis. The patient received anti-tuberculosis drugs for 9 months. The diagnosis of isolated macro-nodular liver tuberculosis is frequently misleading, particularly in immunocompetent and paucisymptomatic patients. Thus percutaneous biopsy is mandatory for diagnosis and also prior to any major surgeries.

Keywords: Liver; Nodular; Tuberculosis.

Publication types

  • Case Reports

MeSH terms

  • Antitubercular Agents / therapeutic use
  • Biopsy
  • Diagnosis, Differential
  • Humans
  • Liver / pathology*
  • Liver Neoplasms
  • Male
  • Middle Aged
  • Seminoma / pathology*
  • Seminoma / therapy
  • Testicular Neoplasms / pathology*
  • Testicular Neoplasms / therapy
  • Tomography, X-Ray Computed
  • Tuberculosis, Hepatic / diagnosis*
  • Tuberculosis, Hepatic / drug therapy

Substances

  • Antitubercular Agents