Liver tuberculoma.

Background: Liver tuberculosis is a fairly rare manifestation of extra-pulmonary tuberculosis. We distinguish several forms of liver affection by tuberculosis. One of these is liver tuberculoma, the incidence of which is quite rare. The authors present a case of liver tuberculoma as an occupational disease.

Methods: A 63-year-old veterinary doctor, who was diagnosed through a polymerase chain reaction with liver tuberculosis, was treated unsuccessfully with anti-tuberculosis drugs for a period of 8 months. After an earlier relapse of the focus in the liver it grew again and created an abscess (80 x 65 x 80 mm), together with a second satellite focus (20 mm). The patient was therefore indicated for a resection of 3 segments of the right liver lobe. The resection was without complications. The polymerase chain reaction, together with histology, proved the presence of a mycobacterium tuberculosis complex. Three year after the surgery, the patient is completely recovered, without any manifestations of the disease.

Conclusions: Liver resection for liver tuberculoma is indicated in case of progression of the finding and long-term unsuccessful treatment with anti-tuberculosis drugs. It is a safe method with very good long-term results (Fig. 2, Ref. 12).