The Diagnostic Dilemma of Ruptured Liver Metastasis in a Patient with Lung Cancer: A case report

Spontaneous rupture of a metastatic liver tumour is rarely documented in literature when compared to hepatocellular carcinoma and other liver lesions, especially from a lung primary. Here we report a case of ruptured liver metastasis from an adenocarcinoma of the lung mimicking ruptured liver abscess, challenging the clinical diagnosis. A 42-year-female presented in July 2020 with complaints of abdominal pain, breathlessness, fever. On examination, the patient was tachypneic with a right hypochondriac mass. A contrast-enhanced computed tomography of abdomen and thorax revealed an ill-defined heterogeneously enhancing lesion in the liver with a communicating subcapsular collection and hypo enhancing lesions in the left lobe and heterogeneously enhancing lesion in the left lung. Adenocarcinoma of the lung with hepatic metastasis was confirmed with a core needle biopsy. The patient was managed conservatively with intravenous antibiotics, intercostal drainage tube and Gefitinib. However, despite best efforts, the patient succumbed to the disease. Keywords: Liver secondaries; Spontaneous rupture; Hepatocellular carcinoma; Thyroid transcription factor; Liver abscess.