Wang YJ, Liu ZC, Wang J, Yang YM. Multiple liver metastases of unknown origin: A case report. World J Gastrointest Oncol 2025; 17(1): 100210 [DOI: 10.4251/wjgo.v17.i1.100210]
Corresponding Author of This Article
Yin-Mo Yang, MD, Department of Hepatobiliary Pancreatic Surgery, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing 100034, China. yangyinmosci@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Oncol. Jan 15, 2025; 17(1): 100210 Published online Jan 15, 2025. doi: 10.4251/wjgo.v17.i1.100210
Multiple liver metastases of unknown origin: A case report
Ying-Jin Wang, Ze-Chuan Liu, Jian Wang, Yin-Mo Yang
Ying-Jin Wang, Yin-Mo Yang, Department of Hepatobiliary Pancreatic Surgery, Peking University First Hospital, Beijing 100034, China
Ze-Chuan Liu, Jian Wang, Department of Interventional and Vascular Surgery, Peking University First Hospital, Beijing 100034, China
Co-first authors: Ying-Jin Wang and Ze-Chuan Liu.
Author contributions: Wang YJ and Liu ZC collected the patient data and drafted the manuscript, they contributed equally to this article, they are the co-first authors of this manuscript; Wang J and Yang YM revised the manuscript; and all the authors read and approved the final manuscript.
Informed consent statement: Informed consent was obtained in writing from the patient to publish this report and any accompanying images. This case has been approved by the patient.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yin-Mo Yang, MD, Department of Hepatobiliary Pancreatic Surgery, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing 100034, China. yangyinmosci@163.com
Received: August 9, 2024 Revised: October 17, 2024 Accepted: November 7, 2024 Published online: January 15, 2025 Processing time: 124 Days and 15.8 Hours
Abstract
BACKGROUND
The liver is the most common site of digestive system tumor metastasis, but not all liver metastases can be traced back to the primary lesions. Although it is unusual, syphilis can impact the liver, manifesting as syphilitic hepatitis with inflammatory nodules, which might be misdiagnosed as metastasis.
CASE SUMMARY
This case report involves a 46-year-old female who developed right upper abdominal pain and intermittent low fever that persisted for more than three months. No definitive diagnosis of a tumor had been made in the past decades, but signs of multiple liver metastases were recognized after a computed tomography scan without evidence of primary lesions. With positive serological tests for syphilis and a biopsy of the liver nodules, a diagnosis of hepatic syphilis was made and confirmed with follow-up nodule reduction after anti-syphilis therapy.
CONCLUSION
Clinicians must be aware of the possibility that syphilis can cause hepatic inflammatory masses, especially when liver metastasis is suspected without evidence of primary lesions. A definitive diagnosis should be established in conjunction with a review of the patient’s medical history for accurate therapeutic intervention.
Core Tip: The liver is the most common metastasis site of digestive system tumor, while not all liver metastases could be traced back to the primary lesions. Syphilis is unusual and impacts the liver manifesting syphilitic hepatitis with inflammatory nodules, which might be misdiagnosed as metastasis. We presented a case showing that when multiple hepatic nodules with primary lesions are confronted, focusing on infectious or self-immune diseases based on the patient’s history might help to answer the final question.
