Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 26, 2022; 10(21): 7409-7414
Published online Jul 26, 2022. doi: 10.12998/wjcc.v10.i21.7409
Solitary necrotic nodules of the liver with "ring"-like calcification: A case report
Jin-Peng Bao, Hu Tian, Hao-Chen Wang, Cong-Cong Wang, Bo Li
Jin-Peng Bao, Hu Tian, Hao-Chen Wang, Department of General Surgery, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan 250014, Shandong Province, China
Cong-Cong Wang, Department of Gastroenterology, Shandong First Medical University, Jinan 250024, Shandong Province, China
Bo Li, Department of General Surgery, Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan 250100, Shandong Province, China
Author contributions: Tian H did the conception and design; Bao JP and Wang HC collected and assembly the data; Wang CC and Li B performed the patient follow-up; Bao JP, Wang HC, and Tian H analyzed and interpreted the data; Bao JP wrote the manuscript; all authors approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hu Tian, MD, PhD, Chief Doctor, Professor, Surgeon, Department of General Surgery, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, No. 16766 Jingshi Road, Lixia District, Jinan 250014, Shandong Province, China. tianhu6585@163.com
Received: November 7, 2021
Peer-review started: November 7, 2021
First decision: January 11, 2022
Revised: January 22, 2022
Accepted: June 3, 2022
Article in press: June 3, 2022
Published online: July 26, 2022
Processing time: 246 Days and 5 Hours
Abstract
BACKGROUND

Solitary necrotic nodule of the liver (SNNL) is a rare benign lesion with a complete necrotic core and a clear fibrous capsule containing elastic fibers. We present the case of a patient with a radiographic computed tomography (CT) finding of "ring"-like annular calcification within the lesion and postoperative pathologic diagnosis of necrotic nodules wrapped by dense fibers in liver tissue, as well as the patient's subsequent management and outcome.

CASE SUMMARY

A 38-year-old Chinese woman with a history of systemic lupus erythematosus treated with prednisone and hydroxychloroquine, without any symptoms, was found to have hepatic space-occupying lesions by imaging examination at a health examination. A subsequent CT scan suggested a space-occupying lesion of the liver with annular calcification, which was not defined to be benign or malignant. After that, a laparoscopic hepatic space-occupying resection was performed. The postoperative pathological diagnosis was necrotic nodules wrapped by dense fibers in the liver tissue, and the final diagnosis was SNNL. The patient had an uneventful postoperative recovery.

CONCLUSION

There is a "ring"-like calcification in SNNL. This patient had a history of systemic lupus erythematosus, without a history of parasite infection, trauma, or tumor. Therefore, whether the etiology and pathological changes of SNNL are related to rheumatic immune diseases remains to be investigated.

Keywords: Solitary necrotic nodules of the liver; Annular calcification; Rheumatic immune disease; Laparoscopic hepatic space-occupying resection; Case report

Core Tip: A 38-year-old woman with a history of systemic lupus erythematosus responded well to corticosteroids (prednisone) and hydroxychloroquine. A liver mass was found on examination, and subsequent computed tomography examination confirmed the liver mass with "ring"-like calcification, and thus malignancy was not ruled out. The patient received surgical treatment, and postoperative pathology showed necrotic nodules surrounded by dense fibers in the liver tissue. There were many lymphocytes and tissue cells around the nodules, which were consistent with isolated necrotic nodules in the liver. The patient is currently being followed.