Clinical Analysis of CT Misdiagnosis of Hepatocellular Carcinoma as Liver Abscess
YANG Ming
LIU Zhenzhong
WANG Zhipeng
LI Ruoxu
DONG Chunjiao
Abstract：Objective To analyze the causes and preventive measures of hepatocellular carcinoma(HCC)misdiag-nosed by CT as liver abscess(LA).Methods The case data of 2 patients with HCC who were misdiagnosed as LA by CT from June 2022 to January 2024 were retrospectively analyzed.Results For 1 patient with abdominal distension and discom-fort,accompanied by abdominal distension,abdominal pain and fever,the possibility of abscess in the right lobe of liver was considered by CT plain scan and enhanced scan.Abdominal magnetic resonance plain scan and dynamic enhanced scan were performed later to indicate tumor,CT-guided biopsy of mass was performed,and puncture pathology showed HCC.HCC was confirmed.The misdiagnosis lasted 18 d.After diagnosis,total resection of HCC(segment Ⅶ)under general anesthesia was performed,and postoperative pathological examination showed moderately differentiated HCC.After six months of follow-up,the patient's condition was stable.One patient suffered from intermittent distension and discomfort in the right quarter,positive percussion pain in the liver area,and elevated liver enzymes,and was diagnosed with LA by CT examination.HCC was con-firmed by rapid pathologic examination during exploratory laparotomy.The misdiagnosis lasted 7 d.Total resection of HCC(segment Ⅶ)was performed after diagnosis,and the postoperative pathological examination showed moderately differentiated HCC.The patient was treated with immunotherapy and followed up for 6 months.Conclusion The early manifestations of HCC are often similar to LA,which is more likely to be misdiagnosed.Therefore,clinicians should strengthen their under-standing of the clinical and imaging manifestations of HCC,closely combine with the clinical practice,carefully differentiate HCC,and timely perform puncture biopsy or surgical pathological examination if necessary to avoid misdiagnosis.
Keywords：Liver neoplasmsCarcinomahepatocellularMisdiagnosisLiver abscessCT examinationPathologi-cal examinationDiagnosisdifferential
Publication Date：2025-02-14
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 17-21 )