case_images: PMC10878015_01
case_images: Diagnostic images during metachronous liver recurrence diagnosis.. Contrast-enhanced CT shows a hypovascular tumor (arrow) in segment V of the liver surface (A) and a hypovascular tumor (arrowheads) with peripheral enhancement in segment IV (B). PET/CT shows the maximum standard uptake value (SUVmax) at the segment V lesion was 3.87 (C, arrow) and the SUVmax at the segment IV lesion was 12.5 (D, arrowheads).
case_images: cureus-0016-00000052657-i01.jpg
case_images: PMC10878015_01_cureus-0016-00000052657-i01.jpg
case_images: FIG1
case_images: Lesions were detected using computed tomography (CT) in liver segments V and IV (Figure 1A, 1B) 21 months after the initial surgery. Both lesions showed FDG accumulation on PET/CT (Figure 1C, 1D).
case_images: Diagnostic images before the second hepatectomy.. Contrast-enhanced CT (A, B) and gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid-enhanced MRI (C, D): The lesion in segment V (arrow) is oval-shaped and slightly enlarged (A); however, the lesion in segment IV (arrowhead) has markedly shrunk in response to chemotherapy (B). The lesion in segment V appears to be within the liver parenchyma (C). The lesion in segment IV is in contact with the root of the middle hepatic vein and the left hepatic vein (D).
case_images: cureus-0016-00000052657-i02.jpg
case_images: PMC10878015_01_cureus-0016-00000052657-i02.jpg
case_images: FIG2
case_images: Chemotherapy reduced the segment IV lesion and slightly enlarged the segment V lesion (Figure 2).
case_images: Resected specimens and pathological examinations.. Macroscopic tumor observation located in segment IV (A). The tumor borders the left hepatic and middle hepatic veins. Pathologically, the diagnosis was a moderately to poorly differentiated adenocarcinoma liver metastasis (B). The gross observation of segment V lesion's divided surface shows silken threads originating from the initial hepatectomy (C). Histologically, it also reveals multinucleated giant cells (arrows) and silk thread fragments (arrowheads) with inflammatory cell infiltration (D). Bars, 50 mum (B, D).
case_images: cureus-0016-00000052657-i03.jpg
case_images: PMC10878015_01_cureus-0016-00000052657-i03.jpg
case_images: FIG3
case_images: Pathologically, the segment IV lesion was preoperatively diagnosed as liver metastasis of adenocarcinoma (Figure 3A, 3B). The segment V lesion was diagnosed as a foreign body granuloma caused by a silk thread core placed in an isolated liver section during the initial hepatectomy (Figure 3C, 3D).