TAILIEUCHUNG - báo cáo khoa học: "Hepatic actinomycosis mimicking an isolated tumor recurrence"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Hepatic actinomycosis mimicking an isolated tumor recurrence | Wayne et al. World Journal of Surgical Oncology 2011 9 70 http content 9 1 70 7 WORLD JOURNAL OF SURGICAL ONCOLOGY CASE REPORT Open Access Hepatic actinomycosis mimicking an isolated tumor recurrence Michael G Wayne Rahul Narang Arif Chauhdry and Justin Steele Abstract Actinomyces species has been described as an opportunistic pathogen particularly in the oral cavity however in rare cases these bacteria can cause actinomycosis which is characterized by formation of abscesses in the mouth lungs or gastrointestinal tract. Actinomycosis was commonly present in the pre-antibiotic era however it has a low prevalence now days. It has been recognized since 150 years ago but because of its variable clinical presentation and indolent course its recognition is difficult and patients are often misdiagnosed. Here we present a case of primary hepatic actinomycosis presenting as a metastatic liver tumor. Case report This is the case of a 65-year-old male who originally presented on August 18 2008 with obstructive jaundice. His past medical history includes diabetes and hypertension. He underwent ERCP with stenting of the bile duct. The patient also had a spiral CT and an endoscopic ultrasound of the pancreas. These tests helped to determine resectability. He underwent a pancreaticoduodenectomy Whipple procedure on Sept. 8 2008 for a pancreatic head adenocarcinoma. He had a standard whipple performed with removal of the gallbladder and distal stomach as well as the head of the pancreas and duodenum. There were no intraoperative events and no gallstones were spilled. He received adjuvant chemotherapy for 7 months. The chemotherapy was gemzar oxali-platinum and tarceva. The patient had routine follow-up and surveillance for recurrence every 4 months the first year and every 6 months for the second year. This included a CT scan and CA 19-9 level. Over the course of one year he was admitted to the hospital on several occasions for low-grade fever for which the diagnosis

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