A Case of Solitary Tuberculoma of the Liver after Hepatectomy

Yasuji Mokuno, Haruhiko Chigira, Takehito Katoh, Yoshihisa Shibata, Shigemi Onoue, Katsushi Yoshida, Satoshi Kamiya, Kiyoshi Hiramatsu, Tetsuya Abe, Minoru Esaki

Department of Surgery, Toyohashi Municipal Hospital

Solitary tuberculoma of the liver is rare. A case of solitary tuberculoma of the liver after hepatectomy is described here. A 49-year-old man was admitted to our hospital, complaining of general fatigue and fever. He had a hepatectomy for a cholangiocarcinoma seven months earlier. Abdominal ultrasonography showed a low echoic, lesion 5 cm in diameter, in the remnant liver. Fine needle aspiration biopsy revealed no malignant finding, and Ziehl-Neelsen stain and culture for acid-fast bacilli were negative. Enhanced CT demonstrated a low-density lesion in the right anterior inferior (S5) and posterior inferior (S6) segment of the liver. Under the diagnosis of recurrent cholangiocarcinoma, partial resection of the liver was performed. The resected specimen showed a firm solid mass measuring 65×60×58 mm. Histological findings revealed a caseous necrotic focus surrounded by the layers of epitheloid cells and fibrosis, which was compatible with tuberculoma. Ziehl-Neelsen stain and periodic acid-Schiff reaction were negative for bacilli and fungi. Histologically, this hepatic tumor was diagnosed as a solitary tuberculoma, although the tubercle bacillus was not in evidence.

Key words
liver tuberculoma, hepatectomy

Reprint requests
Yasuji Mokuno Department of Surgery, Toyohashi Municipal Hospital
50 Hachikannishi Aotake-cho, Toyohashi-shi, 441 JAPAN

Accepted
September 11, 1996

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