Ischemic liver lesions mimicking neoplasm in a patient with severe chronic mesenteric ischemia.

Chronic mesenteric ischemia most frequently presents with abdominal pain, weight loss, and food fear. Ischemic involvement of the liver is infrequent because of the dual blood supply via the portal vein and hepatic artery. Hepatic infarction has been associated with embolization, thrombosis, arterial injury, prothrombotic states, and impairment of portal venous flow. We report a patient with chronic mesenteric ischemia and severe mesenteric arterial disease who presented with large liver masses suspicious for neoplasm. Tissue samples from two hepatic biopsies confirmed ischemic lesions. After open surgical mesenteric revascularization, the patient had complete symptom improvement and nearly complete regression of the liver lesions.