[Solitary liver tumor as a manifestation of polyarteritis nodosa].
METHODS
A 65-year-old female was admitted with fever of unknown origin.


METHODS
Abdominal computed tomography showed a solid mass (7.5 cm in diameter) with central fluid, located in the right lobe of the liver. Fine-needle aspiration cytology was unremarkable. Further work-up procedures for suspected liver abscess included colonoscopy, which surprisingly revealed adenocarcinoma at 13 cm from the anal orifice.


METHODS
Both lesions in the rectum and liver were resected. While a moderately differentiated (G2) adenocarcinoma of the rectosigmoid junction (stage T3/ N0) was confirmed, histology of the hepatic mass showed liver infarction due to polyarteritis nodosa of the medium-sized arteries. Treatment with 20 mg/d prednisolone was initiated and tapered off over the next three months. The clinical course after discontinuation of corticosteroids was unremarkable over a 6-month follow-up.


CONCLUSIONS
It is suggested that polyarteritis nodosa of the liver occurred in this patient as a paraneoplastic phenomenon and subsided after resection of colorectal cancer and short-term immunosuppression with prednisolone.
Bohn
J
J
Medizinische Klinik, Juliusspital Würzburg.
Schippers
E
E
Wagner
S
S
Küsters
W
W
Müller
J
J
Meesmann
M
M
Scheppach
W
W
D000230:Adenocarcinoma / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D000368:Aged; D002763:Cholecystectomy; D003113:Colonoscopy; D003937:Diagnosis, Differential; D005260:Female; D006498:Hepatectomy; D006499:Hepatic Artery / Q000473:pathology; D006801:Humans; D007238:Infarction / Q000175:diagnosis* / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D008099:Liver / Q000098:blood supply* / Q000473:pathology; D008279:Magnetic Resonance Imaging; D009336:Necrosis; D009367:Neoplasm Staging; D010257:Paraneoplastic Syndromes / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D010488:Polyarteritis Nodosa / Q000175:diagnosis* / Q000473:pathology; D012004:Rectal Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D012007:Rectum / Q000473:pathology; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography