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Solitary necrotic nodule of the liver misinterpreted as malignant lesion: considerations on two cases.

Abstract
In our experience, we document 2 cases of a rare and non-tumoral lesion of the liver misinterpreted as necrotic tumor: necrotic solitary nodule. In the first clinical case, ultrasound (US) showed a polylobated lesion (35 x 35 x 38 mm) at segment 8. Color-doppler identified a compression of celiac axis (Dunbar syndrome). Arteriography revealed a subtotal stenosis of celiac tripod soon after the emergence of the left gastric artery. FNAB-CT showed a highly cellulated tissue with a necrotic core surrounded by a fibersclerotic tissue. The patient underwent surgery: cholecystectomy and correction of Dunbar syndrome. US follow-up showed a progressive reduction in diameter of the lesion (24 x 25 x 25 mm at 24 months), suggesting in this case the role of ischemic injury in the pathogenesis of the lesion. In the second clinical case, a hypoechoic lesion (32 x 32 x 30 mm) of segment 6 as occasional US finding during the staging for prostate cancer was shown. FNAC-CT showed a positive result for necrotic cells. Surgical treatment consisted in a wide excision of the lesion. Histologically the lesion was solitary necrotic nodule. The diagnosis of this rare lesion is accidental. In accordance with the literature (50% of cases), we founded an associated tumor. Radiology doesn't differentiate solitary necrotic nodule and other solid lesions. Diagnosis is histological (in our second case, FNAC-CT misinterpreted the tumor as a malignant lesion, while histology showed the real nature of it).
AuthorsM De Luca, B Luigi, C Formisano, A Formato, C De Werra, M Cappuccio, A Loffredo, P Forestieri
JournalJournal of surgical oncology (J Surg Oncol) Vol. 74 Issue 3 Pg. 219-22 (Jul 2000) ISSN: 0022-4790 [Print] United States
PMID10951422 (Publication Type: Case Reports, Journal Article)
Topics
  • Adult
  • Aged
  • Diagnosis, Differential
  • Female
  • Humans
  • Liver (pathology)
  • Liver Diseases (pathology)
  • Liver Neoplasms (pathology)
  • Male
  • Necrosis

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