Incidental hepatic tuberculosis during planned resection of locally advanced ampullary carcinoma: a case report

Vee Chuan Hoe and Allim Khairuddin and Jun Sam Tan and Mohd Sharifudin Sharif and Nornazirah Azizan and Firdaus Hayati (2020) Incidental hepatic tuberculosis during planned resection of locally advanced ampullary carcinoma: a case report. BMC Surgery, 20 (145). pp. 1-4.

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Abstract

Background: Tuberculosis (TB) is classified according to the site of disease as pulmonary or extrapulmonary. Extrapulmonary TB is less common than its counterpart in which it can be found anywhere in the body including the liver. Similar to ampullary carcinoma, TB liver can manifest with jaundice and deranged liver function tests, particularly in the obstructed biliary systems. Case presentation: A 43-year-old gentleman with locally advanced ampullary carcinoma was noticed to have multiple suspicious liver nodules intraoperatively during curative ampulla resection. The surgery was then abandoned after a biopsy. The histology was consistent with chronic granulomatous inflammation. He was then subjected to a Whipple pancreaticoduodenectomy procedure after initiation of anti-tubercular treatment. He recovered well with no evidence of tumour recurrence and worsening TB. Conclusions: A high index of suspicion and quick decision making can help to diagnose a possible extrapulmonary TB masquerading as a malignant disease in a patient with curative intention of ampullary carcinoma.

Item Type: Article
Keyword: Ampullary carcinoma, Hepatic metastasis, Hepatic tuberculosis, Case report
Subjects: R Medicine > R Medicine (General)
Department: FACULTY > Faculty of Medicine and Health Sciences
Depositing User: SITI AZIZAH BINTI IDRIS -
Date Deposited: 15 Sep 2020 15:29
Last Modified: 15 Sep 2020 15:29
URI: https://eprints.ums.edu.my/id/eprint/25953

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