[Mimicry of a XXXX as hepatocellular carcinoma].

@entity1 @entity5572 @entity82 @entity390 @entity39 @entity5 @entity787 @entity1448 @entity733 @entity99 @entity1118 @entity491 @entity8233
HISTORY: We report on a 82 year-old male who presented with @entity1118 in the right upper abdomen, @entity390 and vomitus. An uncomplicated laparoscopic cholecystectomy occurred eight years and a @entity99 60 years before. Clinical examination showed a normal abdominal status without palpable liver, spleen, enlarged lymph nodes or masses. He had no icteric skin and sclera. INVESTIGATIONS: The @entity1 was afebrile without @entity491 . The @entity5 markers @entity787 , CA 19 - 9 and AFP were negative. Ultrasound of the abdomen showed a normal homogeneous echotexture of the liver without signs of @entity1448 or @entity82 . In segment 6 a 3 cm large hypoechoic @entity8233 with a central echogenic structure with acoustic shadowing was noted. Magnetic resonance revealed a 2.8 x 3.6 cm large lesion in the dorsal region of segment 6 of the liver, infiltrating the perihepatic fat. Pathologic lymph nodes and metastases were not found. DIAGNOSIS AND TREATMENT: At laparotomy, the @entity5 appeared to be malignant with invasion to the perirenal fat. Complete resection with negative margins included segment 6 of the liver and the adjacent fat (the kidney itself was not infiltrated). The cut specimen also showed signs of @entity5 with central @entity39 . However, histology of the resected specimen revealed a sterile @entity5572 without @entity5 , but with microscopic foreign bodies. The @entity1 had an uneventful recovery without postoperative complications. CONCLUSIONS: This case report demonstrates the difficulty encountered in the differential diagnosis of inflammatory processes and @entity5 . Chronic inflammatory changes may mimic solid @entity5 . Despite adequate magnetic resonance imaging and thorough intraoperative examination, the correct diagnosis was finally found by histology. The most likely genesis of the @entity733 are lost gallstones during cholecystectomy.
