A 47-year-old man, with a history of anabolic steroid abuse, developed hepatic adenomatosis and multifocal hepatocellular carcinoma. He underwent ultrasound and CT follow-up, showing multiple solid and fluid hepatic lesions. Consequently, hospitalization was required because of high fever (up to 39°C), weakness, and anorexia. An abdominal CT scan revealed an enlargement of one of the intrahepatic fluid collections. Biochemical and microbiological analyses of a fluid sample showed bilirubin and bile acids as well as Streptococcus cristatus and Enterobacter cloacae. Thus, the patient underwent 99mTc-trimethylbromo-iminodiacetic acid scintigraphy, demonstrating bile collection in the lesion with a flow from a bile duct.
From the *Institute of Nuclear Medicine and
†Department of Internal Medicine, Gastroenterology and Hepatology, Università Cattolica del S. Cuore “A. Gemelli,” Rome, Italy.
Received for publication April 11, 2018; revision accepted July 29, 2018.
Conflicts of interest and sources of funding: none declared.
Correspondence to: Daniela Di Giuda, MD, Institute of Nuclear Medicine, Università Cattolica del S. Cuore “A. Gemelli,” L.go A. Gemelli, 8, Rome, Italy. E-mail: firstname.lastname@example.org.