Silent Colon Carcinoma Presenting as a Hepatic Abscess

Abstract

Penetration and abscess formation in an adjacent parenchymal organ as presentation of a colon cancer is very uncommon. We report a rare case of pyogenic liver abscess as the first manifestation of an infiltrative and penetrating hepatic flexure colon carcinoma without liver metastases. A 50-year-old woman was admitted with right abdominal pain, fever and chills. The initial diagnosis was a pyogenic liver abscess. Subsequent CT scan and colonoscopy evidenced a hepatic flexure colon cancer abscessed within segment 6 of the liver. Eight months after a right colectomy and liver resection there was no evidence of disease. The occurrence of a pyogenic liver abscess should raise the suspicion of a silent colon cancer.

Computed Tomographic Colonography Is Valuable for Post-Treatment Evaluation and Screening of Hidden Colorectal Cancer in Patients with Cryptogenic Pyogenic Liver Abscess

“…The evaluation of CTC as an alternative to colonoscopy in the present study contrasted with prior studies that mostly used colonoscopy as a CRC screening tool [9,10,11,12,13,14]. We confirmed that CTC could show intrahepatic abscess lesions to be measured by reviewing results of extracolonic findings.…”

“…A previous large-scale population-based study proved that CTC and colonoscopy strategies resulted in similar detection rates for advanced neoplasia in patients asymptomatic and at average risk for CRC [29]. The included subjects in the present study, however, were all cryptogenic PLA patients at high risk for CRC [9,10,11,12,13,14,15,28]. It is noteworthy that CTC can be a fine screening tool for CRC even in the high-risk patients, and that the radiation dose of CTC is not substantially higher than that of standard computed tomography [30].…”

“…We sought to detect advanced neoplasia, consisting of advanced adenoma and adenocarcinoma, instead of adenocarcinoma alone, whereas most previous reports focused on adenocarcinoma with PLA [9,11,13,15,28]. Considering that targeted detection and removal of advanced adenomas may be the most effective approach to colon cancer prevention [16], we included advanced adenomas for screening.…”

“…PLA is associated with hepatobiliary tract disease or intra-abdominal infections [2]. In addition, PLA has been reportedly related to various colonic diseases, such as inflammatory bowel disease [3,4], diverticulitis [5,6], colonic adenoma [7,8], and colorectal cancer (CRC) [9,10,11,12,13,14,15]. The term ‘cryptogenic PLA' is used when a significant underlying cause of PLA cannot be determined.…”

Rectal cancer presenting as Fusobacterium nucleatum pyogenic liver abscess: A case report

“…There is an increasing association between colonic cancer and liver abscess over the last few years. It has been reported that a pyogenic liver abscess may be associated with, or be the initial presentation of an underlying rectosigmoid or colonic neoplasm [5][6][7].…”