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Medical Science Monitor Basic Research


Homomorphic Adenocarcinoma Metastases to the Liver: A Report of 2 Cases

Challenging differential diagnosis, Diagnostic / therapeutic accidents, Unexpected drug reaction , Rare disease

Simcha Weissman, Tej I. Mehta, Alex Zhornitskiy, Rani Berry, Melanie Burgos, Payman Fathizadeh, James H. Tabibian

USA Department of Medicine, Hackensack University-Palisades Medical Center, North Bergen, NJ, USA

Am J Case Rep 2020; 21:e922932

DOI: 10.12659/AJCR.922932

Available online: 2020-08-20

Published: 2020-09-30


BACKGROUND: Distinguishing between primary and metastatic malignancy can be challenging despite advances in diagnostic imaging, tissue sampling techniques, and immunohistochemistry.
CASE REPORT: Herein, we describe 2 cases of obscure liver lesions which were ultimately determined to be malignant and from metastatic disease. In both cases, the liver metastases were uniquely “homomorphic,” i.e., radiographically resembling the primary tumor source (in the first case a dilated tubular appearance akin to the hepatopancreatic ampulla and in the second case a haustrated bowel appearance akin to the colon).
CONCLUSIONS: These cases illustrate the recently reported concept of tumor homomorphism as a potential diagnostic pearl to facilitate timely diagnosis of malignant-appearing liver lesions of obscure etiology and source and thereby guide management accordingly.

Keywords: Ampulla of Vater, Endoscopy, Digestive System, Liver Neoplasms, Neoplasm Metastasis