Isolated tuberculous liver abscesses with multiple hyperechoic masses on ultrasound: a case report and review of the literature

Abstract

Cases of isolated tuberculous liver abscess are rare. The diagnosis is often delayed or missed because of nonspecific symptoms and the disease's rare occurrence. Less than 25 cases have been documented in the imaging literature to date. This report demonstrates the difficulty in correctly diagnosing local hepatic tuberculosis. We report the case of a 56-year-old male with hepatitis C-related liver cirrhosis and end-stage renal disease treated with hemodialysis, who developed intermittent fever and hepatomegaly with unusual multiple hyperechoic hepatic lesions on ultrasound. To our knowledge, this is only the second reported case of hyperechoic mass-like hepatic lesions on ultrasound and the only case without pulmonary involvement. A greater awareness of this rare clinical entity may prevent needless surgical interventions, because the prognosis of hepatic tuberculous abscess is good for the majority of patients if diagnosed early and prompt, effective treatment is administered.

A Case Report: Isolated Liver Tuberculosis

“…A PCR assay can be done for identification of Mycobacterium tuberculosis in liver biopsy specimens. The importance of establishing the correct diagnosis cannot be overstated, since untreated abdominal tuberculosis carries a 50% mortality rate 10,11 .…”

Isolated tubercular hepatic abscess with diffuse pattern mimicking hepatocellular carcinoma in HIV positive patient: a case report

“…Abdominal tuberculosis has been associated with significant mortality reaching up to 50% in previous studies especially when diagnosis is delayed (Alcantara-Payawal et al, 1997;Chen et al, 2003), hence the objective of this case report is to highlight significance of including hepatic tuberculosis in the differential diagnosis of all cases of hepatomegaly and initiate appropriate investigations, with potential of early treatment and improvement in clinical outcomes.…”

Subphrenic abscess and recurring focal lesions due to tuberculosis in a patient with IgA deficiency

“…6,7 Up to the year 2004, less than 50 hepatic but not perihepatic tuberculous abscesses were reported which were associated with other organ involvement in some cases. 8 We could not find a similar report of tuberculous subdiaphragmatic extrahepatic abscess in the literature.…”