Medicine · 2026
A rare case of syphilitic hepatic inflammatory pseudotumor misdiagnosed as liver metastasis: Case report and mini-review.
СтатьяКлинический случайОбзорНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Wang Jing, Wang Yan, Zhao Ye, Li Shuping
Аннотация
RATIONALE: Syphilitic hepatic inflammatory pseudotumor is an exceedingly rare benign hepatic manifestation of syphilis. Due to its clinical and radiological resemblance to malignant liver tumors, it frequently poses a diagnostic challenge, often leading to potential misdiagnosis as metastatic disease.
PATIENT CONCERNS: A 48-year-old male truck driver presented with a 1-month history of fatigue, decreased appetite, and persistent right upper abdominal discomfort, accompanied by a 5-kg weight loss.
DIAGNOSES: Physical examination revealed tenderness in the right upper abdomen. Laboratory tests showed elevated liver enzymes and systemic inflammatory markers. Imaging (US, CEUS, and computed tomography) initially suggested metastatic liver tumors. However, positive syphilis serology (RPR 1: 780; TPPA positive) and ultrasound-guided liver biopsy, which showed lymphoplasmacytic infiltration and interlobular fibrosis, confirmed the diagnosis of syphilitic hepatic inflammatory pseudotumor.
INTERVENTIONS: The patient received a 3-week course of intramuscular penicillin G (2.4 million units weekly).
OUTCOMES: Following treatment, abdominal symptoms resolved, liver function normalized, and the rapid plasma reagin titer decreased to 1: 100.
LESSONS: This case emphasizes the "great imitator" nature of syphilis in hepatic lesions. Clinicians should include syphilis in the differential diagnosis of atypical hepatic masses, even in patients without high-risk histories, to avoid unnecessary invasive procedures or misdiagnosis.
PATIENT CONCERNS: A 48-year-old male truck driver presented with a 1-month history of fatigue, decreased appetite, and persistent right upper abdominal discomfort, accompanied by a 5-kg weight loss.
DIAGNOSES: Physical examination revealed tenderness in the right upper abdomen. Laboratory tests showed elevated liver enzymes and systemic inflammatory markers. Imaging (US, CEUS, and computed tomography) initially suggested metastatic liver tumors. However, positive syphilis serology (RPR 1: 780; TPPA positive) and ultrasound-guided liver biopsy, which showed lymphoplasmacytic infiltration and interlobular fibrosis, confirmed the diagnosis of syphilitic hepatic inflammatory pseudotumor.
INTERVENTIONS: The patient received a 3-week course of intramuscular penicillin G (2.4 million units weekly).
OUTCOMES: Following treatment, abdominal symptoms resolved, liver function normalized, and the rapid plasma reagin titer decreased to 1: 100.
LESSONS: This case emphasizes the "great imitator" nature of syphilis in hepatic lesions. Clinicians should include syphilis in the differential diagnosis of atypical hepatic masses, even in patients without high-risk histories, to avoid unnecessary invasive procedures or misdiagnosis.