A patient is described in whom the first recurrence of a cloacogenic carcinoma of the rectum was an intrahepatic metastasis associated with an hepatic abscess caused by the anaerobic bacterium Peptococcus prevotii. Three previously reported cases of infection associated with hepatic tumor nodules have been found in which bacteriologic data were provided, and in all three cases anaerobic bacteria were the primary or only infecting organisms. Experimental data exist which document the ability of certain anaerobic bacteria to grow selectively in tumor nodules, but not in the normal tissues of a tumor-bearing host. Since 23% of patients with liver metastases have fever and offer a clinical picture compatible with infection, occult anaerobic infection associated with liver metastases may be more common than previously recognized.Cancer 41:682-686, 1978.
HE CLINICAL AND BACTERIOLOGIC PICTURE OFT pyogenic abscess of the liver has been well defined. 10719*33 Recent reviews emphasize the importance of anaerobic bacteria in the etiology of hepatic suppuration. 14, 34 In the majority of patients with hepatic abscess, the illness begins in an extrahepatic focus of infection with subsequent spread to the liver by way of the portal or systemic circulation or the biliary tree. Hepatic abscess may also arise as a direct extension of adjacent upper abdominal suppuration or as a complication of blunt or penetrating trauma to the liver. Several authors have noted that suppuration may complicate metastatic tumors in the liver. 2*3*5~'~18~1'931~32Robertson et al. reported a series of 37 patients with liver abscess in which seven cases occurred in patients with intrahepatic tumor nodules. 32 Well-documented examples of intrahepatic infection and metastases are, however, rare. 3~11*32The present report describes a patient who, one year following resection of a cloacogenic carcinoma of the rectum, presented with a large intrahepatic abscess whose walls contained met-