Atypical Presentation for Colorectal Cancer

Abstract

Bowel cancer is the second most common non-cutaneous cancer diagnosed in Australia in both the sexes. Australia has one of the highest incidence of bowel cancer in the world. Pyogenic liver abscess has been reported to be associated with malignancy especially hepatobiliary and colorectal cancer. A healthy 70 years old woman presented with non-specific symptoms which was initially thought to be secondary to haematological malignancy. Further investigation noted multiple large cystic and solid hepatic masses, which were suggestive of metastasis. However, hepatic lesions responded significantly with antibiotics which was in keeping with liver abscess instead. She was subsequently confirmed to have caecal adenocarcinoma with no distant metastasis. Although uncommon, pyogenic liver abscess can be the first presentation for colorectal malignancy. Colonoscopy is essential especially if no clear cause of liver abscess is identified.