Primary squamous cell carcinoma of the liver masquerading as a liver abscess

Song, Jeong Eun; Jeong, Jaehong; Song, Jeong Eun; Jeong, Jaehong

Clin Ultrasound > Accepted Articles

Jeong Eun Song, Jaehong Jeong

Department of Internal Medicine, Daegu Catholic University School of Medicine, Daegu, Korea

Address for Correspondence:

Jeong Eun Song ,Tel: +82-53-650-3517, Fax: +82-53-656-3281, Email: ssong3004@naver.com

Received: 6 May 2024; Accepted: 13 May 2024. Published online: 13 May 2024.

ABSTRACT

This case was diagnosed as a liver abscess based on clinical presentation, blood tests, and abdominal CT scans, but characteristic findings of a liver abscess were not observed on ultrasound. Therefore, a liver biopsy was performed, and the biopsy results diagnosed primary squamous cell carcinoma of the liver. The ultrasound findings of a liver abscess can vary depending on the healing stage and maturity of the abscess. Initially, a liver abscess may appear as a local increase in echo with unclear boundaries, and as it progresses, an abscess wall forms, the boundaries become more defined, and the echo decreases as the contents liquefy. In the case of immature liver abscesses, before internal liquefactive necrosis occurs, they show a solid echo pattern, necessitating differentiation from hepatocellular carcinoma, metastatic liver cancer, and necrotic liver masses. Fever and leukocytosis, which are characteristic clinical features, can aid in this differentiation. However, if the clinical course shows typical symptoms of a liver abscess but not the corresponding ultrasound findings, the possibility of malignancy should be considered, and further aggressive tests such as a liver biopsy are needed for differentiation.

Keywords: Pyogenic Liver Abscess; Squamous Cell Carcinoma; ultrasonography