The diagnostic dilemma of ruptured liver metastasis in a patient with lung cancer : a case report

الملخص EN

Spontaneous rupture of a metastatic liver tumour is rarely documented in the literature when compared to hepatocellular carcinoma and other liver lesions, especially from a lung primary.

We report a case of ruptured liver metastasis from an adenocarcinoma of the lung mimicking ruptured liver abscess, challenging the clinical diagnosis.

A 42-year-female patient presented to a tertiary care institute in 2020 with complaints of abdominal pain, breathlessness and fever.

On examination, the patient was tachypnoeic with a right hypochondriac mass.

A contrast-enhanced computed tomography of abdomen and thorax revealed an ill-defined heterogeneously enhancing lesion in the liver with a communicating subcapsular collection and hypo-enhancing lesions in the left lobe and heterogeneously enhancing lesion in the left lung.

Adenocarcinoma of the lung with hepatic metastasis was confirmed with a core needle biopsy.

The patient was managed conservatively with intravenous antibiotics, intercostal drainage tube and gefitinib.

However, despite best efforts, the patient succumbed to the disease.