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Enlarged solitary necrotic nodule of the liver misinterpreted as a metastatic liver cancerKazuhiro OtaniKazuo ChijiiwaKazuhiro KondoMai TsuchimochiNobuyasu TakahashiNaoki IkenagaJiro OhuchidaHiroyuki TanakaHiroaki KataokaCase ReportDOI:
10.-009-0103-yOtani, K., Chijiiwa, K., Kondo, K. et al. Clin J Gastroenterol (5. doi:10.-009-0103-y
Solitary necrotic nodule of the liver is a rare nonmalignant lesion of unknown etiology. It is defined as a nodule with a completely necrotic core enclosed by a hyalinized fibrotic capsule containing elastic fiber. We report a 74-year-old woman with a solitary necrotic nodule of the liver that mimicked metastasis from a previous rectal adenocarcinoma. She was referred to us for an asymptomatic liver nodule in segment 8 that had increased in diameter from 5 to 15 mm over the past 8 months. Ultrasonography showed a well-defined, oval, hypoechoic mass, and computed tomography showed a hypodense area without contrast enhancement except for a ring-like enhancement during hepatic arteriography. Magnetic resonance imaging revealed a mass that was hypointense on T1-weighted imaging and slightly hyperintense on T2-weighted imaging. The patient underwent hepatectomy of segment 8. The resected specimen contained an oval nonencapsulated nodule with firm and gritty consistency and a well-defined margin. Histologic findings were compatible with those of solitary necrotic nodule. Clinicians should recognize the existence of this lesion as one of the differential diagnoses of metastatic liver nodule. Solitary necrotic nodules can change size, and when enlarged, differentiation from metastasis is extremely difficult.Necrotic nodule Liver Metastasis 1.Shepherd NA, Lee G. Solitary necrotic nodules of the liver simulating hepatic metastases. J Clin Pathol. 1–3.2.Yoon KH, Yun KJ, Lee JM, Kim CG. Solitary necrotic nodules of the liver mimicking hepatic metastasis: report of two cases. Korean J Radiol. –8.3.Koea J, Taylor G, Miller M, Rodgers M, McCall J. Solitary necrotic nodule of the liver: a riddle that is difficult to answer. J Gastrointest Surg. –30.4.De Luca M, Luigi B, Formisano C, Formato A, De Werra C, Cappuccio M, et al. Solitary necrotic nodule of the liver misinterpreted as malignant lesion: considerations on two cases. J Surg Oncol. –22.<a class="gtm-reference" data-reference-type="CrossRef" target="_blank" rel="noopener noreferrer" href="http://dx.doi.org/10.98(%3A3CrossRef5.Koea J, Smith D. Solitary necrotic nodule revisited. ANZ J Surg. –11.6.Tsui WM, Yuen RW, Chow LT, Tse CC. Solitary necrotic nodule of the liver: parasitic origin? J Clin Pathol. –8.7.Berry CL. Solitary “necrotic nodule” of the liver: a probable pathogenesis. J Clin Pathol. 8–80.8.Sundaresan M, Lyons B, Akosa AB. ‘Solitary’ necrotic nodules of the liver: an aetiology reaffirmed. Gut. 8–80.9.Alfieri S, Carriero C, Doglietto GB, Pacelli F, Crucitti F. Solitary necrotic nodule of the liver: diagnosis and treatment. Hepatogastroenterology. 0–1.10.Iwase K, Higaki J, Yoon HE, Mikata S, Miyazaki M, Torikai K, et al. Solitary necrotic nodule of the liver. J Hepatobiliary Pancreat Surg. –4.11.Colagrande S, Politi LS, Messerini L, Mascalchi M, Villari N. Solitary necrotic nodule of the liver: imaging and correlation with pathologic features. Abdom Imaging. –4.12.Marongiu L, Capra F, Cautero N, Pinna AD. Solitary necrotic nodule of the liver: diagnostic and therapeutic considerations regarding a case. Chir Ital. –70.13.Imura S, Miyake K, Ikemoto T, Morine Y, Fujii M, Sano N, et al. Rapid-growing solitary necrotic nodule of the liver. J Med Invest. –9.14.Kondi-Pafiti AI, Grapsa DS, Kairi-Vasilatou ED, Voros DK, Smyrniotis VE. “Solitary” necrotic nodule of the liver: an enigmatic entity mimicking malignancy. Int J Gastrointest Cancer. –8.15.Wang Y, Yu X, Tang J, Li H, Liu L, Gao Y. Solitary necrotic nodule of the liver: contrast-enhanced sonography. J Clin Ultrasound. –81.16.Clouston AD, Walker NI, Prociv P. Parasitic origin of a solitary necrotic nodule of the liver. J Clin Pathol. .17.Zhou YM, Li B, Xu F, Wang B, Li DQ, Liu P, et al. Clinical features of solitary necrotic nodule of the liver. Hepatobiliary Pancreat Dis Int. –9.18.Truant S, Huglo D, Hebbar M, Ernst O, Steinling M, Pruvot FR. Prospective evaluation of the impact of [18F]fluoro-2-deoxy-D-glucose positron emission tomography of resectable colorectal liver metastases. Br J Surg. –9.Kazuhiro Otani1Kazuo Chijiiwa1Kazuhiro Kondo1Mai Tsuchimochi1Nobuyasu Takahashi12Naoki Ikenaga1Jiro Ohuchida1Hiroyuki Tanaka2Hiroaki Kataoka21.Department of Surgical Oncology and Regulation of Organ FunctionMiyazaki University School of MedicineMiyazakiJapan2.Department of PathologyMiyazaki University School of MedicineMiyazakiJapan
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