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CC BY 4.0 · Surg J (N Y) 2020; 06(04): e180-e184
DOI: 10.1055/s-0040-1721428
Case Report

Pyrexia of Unknown Origin: An Atypical Presentation of Hepatic Hemangioma

Gunjan Desai
1   Department of Surgical Gastroenterology, MGM New Bombay Hospital, Navi Mumbai, Maharashtra, India
,
Dattaraj Budkule
2   Department of General Surgery, Lilavati Hospital and Research Centre, Mumbai, Maharashtra, India
,
Prasad Pande
1   Department of Surgical Gastroenterology, MGM New Bombay Hospital, Navi Mumbai, Maharashtra, India
,
Prasad Wagle
3   Department of Surgical Gastroenterology, Lilavati Hospital, Mumbai, Maharashtra, India
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Abstract

Pyrexia of unknown origin (PUO) has been a diagnostic challenge for decades. Hepatic hemangioma (HH) is not a common differential diagnosis of PUO. It is the most common benign hepatic tumor, commonly asymptomatic and incidentally detected, or can present with vague abdominal pain. PUO is a rare presenting feature. We describe a case of 38-year-old lady presenting with PUO. With no other identifiable source of fever despite exhaustive investigations, a giant hemangioma in right lobe of liver detected on abdominal ultrasonography was deemed to be the cause of PUO. The patient had sudden decrease in hemoglobin while undergoing workup, which on imaging showed a bleeding hemangioma and right hepatectomy was performed. Patient had an uneventful recovery and her PUO also resolved after surgery. HH should be considered a rare diagnosis of exclusion for PUO after a standard algorithmic approach does not reveal any other cause.

Keywords

liver tumor - transarterial embolization - liver resection

Grants/Other Financial Support Financial Support

None.

Compliance with Ethical Standards


Ethics Statement

The study was performed after the approval of research protocols by the Ethics Committee of Lilavati Hospital and Research Centre in accordance with international agreements (World Medical Association Declaration of Helsinki “Ethical Principles for Medical Research Involving Human Subjects,” amended in October 2013, www.wma.net)


Informed Consent

Written informed consent was obtained from the patient involved in the study.


Author Contributions

Gunjan Desai was involved in collecting data, analysis of data, preparing the initial draft of the manuscript, critical revision of the manuscript for intellectual content, technical support, material support, study supervision


Dattaraj Budkule was involved in collecting data, analysis of data, preparing the initial draft of the manuscript


Prasad Pande was involved in critical revision of the manuscript for intellectual content, technical support, material support, study supervision


Prasad Wagle was involved in study concept, critical revision of the manuscript for intellectual content, administrative, technical support, material support, study supervision.


Financial Disclosure

The authors declare that this study has received no financial support.


Pyrexia of Unknown Origin

An atypical presentation of a giant hepatic hemangioma.




Publikationsverlauf

Eingereicht: 30. Mai 2020

Angenommen: 11. September 2020

Artikel online veröffentlicht:
14. Dezember 2020

© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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