CASE 602: HEPATIC ABSCESS MIMICKING HCC in CHRONIC HBV PATIENT, Dr PHAN THANH HẢI, Dr TRẦN THÙY TRANG, MEDIC MEDICAL CENTER, HCMC, VIETNAM

Male patient 36yo with HBV infection  known by himself since November 2019 without treatment.

Ultrasound at Medic Center showed a 39x22mm mass in right lobe on chronic hepatitis # F 3.

•      US 1: Ultrasound detect an ill-defined, hypoechoic mass #4cm (with a small cyst in center) in hepatic segment VI.

•      US 2: Superb microvascular imaging (SMI) shows small blood vessels in tumor.

•      US 3, 4: Elastography shows that the stiffness of the tumor and its outline are harder than the liver parenchyma.

Lab results: HBsAg +; HBeAg +; HBV DNA =62,953U/mL; AFP=5.97. Wako tests=AFP L3 <0.5, PIVKA II(DCP)=19

MRI with Gado thought about 36x30mm HCC= T2 higher signal than liver; T1 lower signal. Gado caught more in arterial phase, in late phase lower signal than liver.

Operation removed the liver mass 

and histopathologic report said liver tissue inflamed with majority of eosinophil leucocytes.