Pyogenic Liver Abscess Mimicking Liver Neoplasm on Computed Tomography Scan in a Patient With Elevated CA 19-9

Abstract

Pyogenic liver abscess (PLA) presentation on computer tomography (CT) scan depends mainly on the degree of maturation and internal contents, but rarely presents similarly to primary liver cancer (PLC) or hepatic metastasis. However, distinguishing PLA from PLC can be a challenge, and several cases were reported previously where tumor markers helped in this differentiation. We present a rare case of PLA with radiological findings similar to PLC or liver metastasis on CT scan in a patient with elevated tumor marker, carbohydrate antigen (CA) 19-9. This case illustrates that a combination of risk factors and clinical findings including localizing symptoms, fever, leukocytosis and tumor markers has to accompany image findings to reach an appropriate differentiation in a query case of hepatic lesion.