Misdiagnosis of patients with solitary liver metastasis as the first finding for hospitalization
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To summarize the experience of diagnosis for solitary liver metastasis as the patient's first finding for hospitalization and the cause of misdiagnosis for this kind of diseases.
From July 2000 to March 2002, 10 cases of solitary space occupying lesion in liver as the first clinical finding were admitted to our department. Besides the routine blood test after admission, serum AFP, CEA and CA-199 were determined in all patients. Colonoscopy was performed on the patients suspected with primary cancer in colon or rectum.
The diagnosis of hepatic metastasis was finally made in all patients after admission, based on the findings of the primary tumor in other organs. The metastatic tumor was from gastric cancer in 2 cases, from colorectal cancer in 7 cases and from malignant lymphoma in 1 case. The diameters of the metastatic tumor ranged from 4.5 to 12.4 cm with a mean diameter of 7.8±2.5 cm. The misdiagnosis rate in outpatient department was 60%. In 9 patients, the liver metastatic tumors and the primary tumors were resected at the same time. All of them recovered and discharged uneventfully.
Because of its low morbility, the solitary liver metastasis can be easily misdiagnosed if the patients only have a single space occupying lesion in liver as the first finding when they come to hospital. Fully recognition of the disease and complete imaging examinations are both necessory to make a correct diagnosis. The treatment for these patients is, if possible, to resect the liver metastatasis and the primary tumor simultaneously.
Key wordsliver metastasis diagnosis analysis of misdiagnosis operation
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