27 March 2016 : Case report
Multifocal Nodular Fatty Infiltration of the Liver: A Case Report of a Challenging Diagnostic Problem
Challenging differential diagnosis, Diagnostic / therapeutic accidents, Rare disease, Educational Purpose (only if useful for a systematic review or synthesis)Giovanni Domenico TebalaABCDEF, Anees JwadBDF, Abdul Quyyum KhanBCF, Ervine LongABCD, Guy SissonsBCDE
Am J Case Rep 2016; 17:196-202
BACKGROUND: Fatty infiltration of the liver usually has a diffuse pattern, but in very rare cases it presents as multiple focal lesions of the liver, mimicking metastases. A correct diagnosis is crucial to address prognosis and eventual treatment.
CASE REPORT: We present the case of a completely fit and asymptomatic patient referred for multiple bilateral liver metastases of unknown origin. She had no previous history of malignancy. She was extensively investigated with all locally available methods, including ultrasound scan, computed tomography, magnetic resonance imaging, upper and lower gastrointestinal endoscopy, and diagnostic laparoscopy. Imaging-guided biopsy and laparoscopic biopsy confirmed the diagnosis of multifocal fatty infiltration of the liver.
CONCLUSIONS: The diagnosis of this condition can be challenging and an accurate initial clinical history must be part of a thorough clinical examination. Multimodal imaging is mandatory, but diagnostic laparoscopy with direct macrobiopsy may be necessary to clear all doubts.
Keywords: Fatty Liver - diagnosis, Diagnosis, Differential, Female, Liver Neoplasms - diagnosis, Middle Aged
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