This is a 31-year-old male patient, native of Senegal, who came to the emergency department for abdominal pain and fever.
Her family history showed that her mother and grandmother had died of liver disease.
She had previously known pathology.
She reported abdominal pain, especially in the right hypochondrium, and fever of 38.5 oC within 48 hours prior to admission.
He also had a 3-month history of asthenia, anorexia and significant loss.
On examination carried out in the emergency room the patient was febrile, tachycardic and with great affection for pain; on examination of the abdomen a great pain was observed in the right hypochondrium with signs of peritoneal irritation.
Laboratory tests revealed mild stasis and hypoalbuminemia.
An emergency CT scan showed a solid and liquid mass that could correspond to a liver abscess.
Ultrasonography shows a large solid mass, 13 cm, larger, with a more hypoechoic sub-region that could be more hypoechoic. This could be due to the presence of multiple possible areas of hemorrhage right vein thrombosis, tumor relationship with diameter and mostly stenosis.
These findings were confirmed by MRI.
Subsequently, with the reasonable doubt established in the CT and before obtaining the tumor markers, a FNA of the liver mass was performed, whose result was compatible with epithelial tumor.
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Subsequent viral serology showed positivity for chronic hepatitis B and alpha-fetoprotein was 1,260 ng/ml.
The patient was diagnosed with chronic HBV infection complicated with a multicentric HCC.
Palliative treatment was started to control symptoms and the patient died 3 months later.
