title: Rapid-growing solitary necrotic nodule of the liver.
abstract: The solitary necrotic nodule of the liver is an uncommon nonmalignant lesion with an uncertain etiology. The lesion was defined as a nodule with a completely necrotic core and fibrous capsule etc. and without a consistency of viable cells. The characteristic features of this benign lesion on the imaging modalities are similar to the metastatic tumor. In this paper we discuss the case of a rapid-growing solitary necrotic nodule of the liver occurring in a patient with chronic renal failure on hemodialysis. The lesion located on the left median lobe of the liver had rapidly enlarged in diameter in the last seven months. Despite some examinations by imaging modalities to confirm the preoperative diagnosis, we were unable to visually confirm. Several histological examinations using a needle biopsy specimen were performed, but the diagnosis was all necrotic tissue. However, we recommended an extended left hepatic lobectomy for this rapid-growing lesion since cholangiocarcinoma with necrosis could be hardly differentiated. Permanent histology revealed that the lesion was solitary necrotic nodule. We consider that permanent histology of the entire lesion is possibly the only accurate method of diagnosis. Since the solitary necrotic nodule does not indicate malignancy, hepatic resection should be performed.
authors.affiliation: Department of Digestive and Pediatric Surgery, Institute of Health Biosciences, The University of Tokushima Graduate School.
authors.forename: Satoru
authors.initials: S
authors.lastname: Imura
authors.forename: Kotaro
authors.initials: K
authors.lastname: Miyake
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Ikemoto
authors.forename: Yuji
authors.initials: Y
authors.lastname: Morine
authors.forename: Masahiko
authors.initials: M
authors.lastname: Fujii
authors.forename: Nobuya
authors.initials: N
authors.lastname: Sano
authors.forename: Mitsuo
authors.initials: M
authors.lastname: Shimada
mesh_terms: D001650:Bile Duct Neoplasms / Q000175:diagnosis; D001653:Bile Ducts, Intrahepatic; D001707:Biopsy, Needle; D049109:Cell Proliferation; D018281:Cholangiocarcinoma / Q000175:diagnosis; D003937:Diagnosis, Differential; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008099:Liver / Q000473:pathology / Q000601:surgery; D008107:Liver Diseases / Q000175:diagnosis* / Q000473:pathology* / Q000601:surgery; D008875:Middle Aged; D009336:Necrosis; D006435:Renal Dialysis; D051437:Renal Insufficiency / Q000628:therapy