Solitary necrotic nodule of the liver mimicking hepatocellular carcinoma: a case report

Abstract

IntroductionSolitary necrotic nodule of the liver is a rare lesion, with similar radiologic findings to those of hepatic metastases or other liver masses.Case presentationWe here report a case of a 30-year-old male with hepatic solitary necrotic nodule discovered after an episode of acute abdominal pain and high grade fever. Routine laboratory data revealed leukocytosis and abnormal liver function. The imaging features of the lesion suggested malignancy or liver adenoma. The patient underwent surgical resection of segments V and VI. Histology was compatible with solitary necrotic nodule and localized vein thrombosis at the periphery.ConclusionSolitary necrotic nodule of the liver is a benign lesion which can mimic liver malignancies. Abdominal imaging and liver biopsy are often equivocal. In such circumstances liver resection is mandatory to exclude HCC or other malignant liver lesions.

Solitary Necrotic Nodule of the Liver: Always Benign?

“…5 It is reported that the lesion is more prevalent in older patients, and majority of the patients were in the seventh and eighth decades of life. 6 The study of Zhou et al which reviewed the 68 previously reported SNNL cases pointed out a percentage of 57.4% with male predominancy which was slightly higher than our series (50%). They also showed mean age of 57.5 with a range of 27 to 85 years.…”

Spontaneous regression of a solitary necrotic nodule of the liver

“…The outer layer shows normal hepatocytes (hematoxylin and eosin stained section, magnification 9200) treatment. The treatment options for a solitary necrotic nodule are based on the severity of the case [9]. Although all patients with solitary necrotic nodule undergo surgical treatment, our case illustrates that some patients may not require surgery.…”

“…Generally, most patients have no abdominal symptoms. However, intermittent abdominal pain or discomfort has been reported in some patients [3,9].…”

“…Because of the concern about a possible malignancy, surgery was performed in all the cases reported in the literature; in other cases, the lesion was detected at autopsy [3,8,9]. Therefore, the natural course and prognosis of these lesions remains unknown.…”

“…On the basis of the clinical manifestations, history, and laboratory and imaging findings, a solitary necrotic nodule of the liver was suspected before surgery in only 7.8% of patients [3,11]. The findings of a liver biopsy are often equivocal [9]; however, liver biopsy is important for definitive diagnosis and for planning the appropriate Fig. 4 The histological examination of the liver biopsy sample showed central necrotic tissue surrounded by a borderline zone containing infiltrative inflammatory cells and fibrotic changes.…”