Liver metastasis mimicking an abscess

Imrani, Kaoutar; Oubaddi, Tlaite; Jerguigue, Hounayda; Latib, Rachida; Omor, Youssef

doi:10.1259/bjrcr.20200201

Cited by 3 publications

(7 citation statements)

References 9 publications

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“…Fine‐needle aspiration cytology is highly sensitive for accurately diagnosing both primary and metastatic hepatic tumors 11,13 . A differential diagnosis of metastatic neuroendocrine tumor was considered based on cytomorphological evaluation in the current case.…”

Section: Discussionmentioning

confidence: 98%

“…Hepatic metastases from untreated NETs are usually solid and show involvement of bilateral liver lobes. 8,11 In occasional cases, they may have cystic appearance and thus are liable to be misinterpreted as benign lesions. 8 Also, there might be secondary cystic changes in hepatic NET metastasis due to tumor necrosis following chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

“…12 Fine-needle aspiration cytology is highly sensitive for accurately diagnosing both primary and metastatic hepatic tumors. 11,13 A differential diagnosis of metastatic neuroendocrine tumor was considered based on cytomorphological evaluation in the current case. With supportive immunocytochemical staining for neuroendocrine markers, FNA enabled the confirmed diagnosis of cystic NET.…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of primary or metastatic hepatic malignancies with pseudocystic appearances is overall less. Hepatic metastases from untreated NETs are usually solid and show involvement of bilateral liver lobes 8,11 . In occasional cases, they may have cystic appearance and thus are liable to be misinterpreted as benign lesions 8 .…”

Section: Discussionmentioning

confidence: 99%

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Cystic hepatic metastases in treatment naïve neuroendocrine tumor: Cytomorphology clubbed with cell block immunocytochemistry clinches the diagnosis

Shastri

Kundu

Krishnaraju

et al. 2022

Diagnostic Cytopathology

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Cystic hepatic lesions encompass a vast spectrum of infectious, non‐neoplastic, and neoplastic entities. Most hepatic cysts are benign and asymptomatic, requiring no active intervention. However, symptomatic and malignant cysts need proper evaluation and specific treatment. An accurate preoperative diagnosis is pivotal for patient management. At times, these lesions may mimic, especially symptomatology and radiology, leading to a diagnostic ordeal. We herein present a case of a patient with cystic liver lesions in a treatment naïve neuroendocrine tumor that was a diagnostic dilemma on radiology. Low cellularity of cytology smears made the diagnosis challenging, and cell block immunocytochemistry finally clinched the diagnosis. A timely diagnosis provided on cytology fuelled further work‐up, the discovery of primary tumor, and initiation of appropriate therapy.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Cystic hepatic metastases in treatment naïve neuroendocrine tumor: Cytomorphology clubbed with cell block immunocytochemistry clinches the diagnosis

Shastri

Kundu

Krishnaraju

et al. 2022

Diagnostic Cytopathology

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“…The differential diagnoses of the hepatic cystic lesion can be divided into developmental, inflammatory, neoplastic, and trauma-related lesions ( 6 , 16 ). Liver abscess is an important differential diagnosis for cystic hepatic metastases due to the complex symptoms or the indeterminate imaging features ( 17 ). In order to achieve more definitive diagnosis, it is necessary to integrate imaging examination with clinical and laboratory findings.…”

Section: Discussionmentioning

confidence: 99%

Case report: Rare isolated cystic hepatic metastasis of a patient with squamous cell lung carcinoma history and the prognosis

Liu

Chen²,

Su³

et al. 2022

Front. Oncol.

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Cystic hepatic metastasis of squamous cell carcinoma usually develops from necrosis due to insufficient blood supply, yet metastasis initially resembling simple liver cyst is rare. Here, we present a case of a patient with squamous cell lung carcinoma history who found an isolated cystic mass in the liver. Historical MR studies indicated that the mass did not exist 12 months ago and emerged as a small cystic lesion 7 months ago. Radiological findings and tumor markers level suggested metastasis, while 18F-Fluorodeoxyglucose (18F-FDG) PET/CT showed moderate tracer uptakes in solid parts of the mass. Pathological study after surgery confirmed metastatic squamous cell carcinoma. Chemotherapy plus recombinant human endostatin and sintilimab therapy was employed after surgery; however, the patient developed remote metastasis of osteolytic lesions in the humerus bone and thoracic vertebra. Our case indicates that metastasis should be taken into consideration in emerging cystic hepatic lesion with malignant history.

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Cytology as the guiding light: Prompt cytomorphologic diagnosis of cystic metastases from a jejunal neuroendocrine tumor masquerading as hepatic abscesses

Tom

Singh

Gupta

et al. 2023

Diagnostic Cytopathology

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Hepatic cystic lesions are commonly seen in radiology and can occur due to infective or neoplastic causes. It is imperative to determine the precise nature of these hepatic cysts owing to significant therapeutic and prognostic differences. Hepatic metastases from gastrointestinal neuroendocrine tumors (NETs) mostly present as solid hypervascular lesions. Cystic presentation of the metastatic NETs is extremely rare. A 64-year-old woman presented with an abdominal lump of 3 months duration and high-grade fever from the last 2 days. An ultrasound abdomen revealed multiple hypoechoic liver lesions suggestive of liver abscesses. An ultrasound-guided fineneedle aspiration (FNA) from the cystic liver lesions revealed a NET confirmed by immunocytochemistry. The Ki-67 index was 5%; hence, a final diagnosis of metastatic NET, grade 2, was given with advice to work up for localizing the primary tumor. Subsequently, a contrast-enhanced computerized tomography of the abdomen revealed a polypoidal lesion in the proximal jejunum, which showed intense expression on the whole-body DOTANOC scan (SUVmax-76.5), indicating it to be the likely primary tumor along with somatostatin receptor-expressing multiple lymph nodes and hypodense liver lesions. Thus, a final diagnosis of a jejunal NET with abdominal lymph node and liver metastases was made. The present report highlights the importance of FNA as a reliable modality in diagnosing metastatic NETs presenting as unusual cystic hepatic metastases masquerading as liver abscesses. Additionally, the cell block helps confirm the cytologic diagnosis and enables upfront tumor grading, thereby helping in prognostication and therapeutic decision-making.

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Liver metastasis mimicking an abscess

Cited by 3 publications

References 9 publications

Cystic hepatic metastases in treatment naïve neuroendocrine tumor: Cytomorphology clubbed with cell block immunocytochemistry clinches the diagnosis

Cystic hepatic metastases in treatment naïve neuroendocrine tumor: Cytomorphology clubbed with cell block immunocytochemistry clinches the diagnosis

Case report: Rare isolated cystic hepatic metastasis of a patient with squamous cell lung carcinoma history and the prognosis

Cytology as the guiding light: Prompt cytomorphologic diagnosis of cystic metastases from a jejunal neuroendocrine tumor masquerading as hepatic abscesses

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