A case of leptospirosis simulating colon cancer with liver metastases

doi:10.3748/wjg.v10.i16.2455

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Aug 15, 2004 (publication date) through Apr 22, 2024

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Gastroenterol. Aug 15, 2004; 10(16): 2455-2456
Published online Aug 15, 2004. doi: 10.3748/wjg.v10.i16.2455

A case of leptospirosis simulating colon cancer with liver metastases

Alessandro Granito, Giorgio Ballardini, Marco Fusconi, Umberto Volta, Paolo Muratori, Vittorio Sambri, Giuseppe Battista, Francesco B. Bianchi

Alessandro Granito, Giorgio Ballardini, Marco Fusconi, Umberto Volta, Paolo Muratori, Francesco B. Bianchi, Departments of Internal Medicine, Cardioangiology, Hepatology, Alma Mater Studiorum - University of Bologna, Italy

Vittorio Sambri, Department of Clinical and Experimental Medicine, Section of icrobiology, Alma Mater Studiorum - University of Bologna, Italy

Giuseppe Battista, Department of Radiology, Alma Mater Studiorum-University of Bologna, Italy

Author contributions: All authors contributed equally to the work.

Correspondence to: Alessandro Granito, MD, Dipartimento di Medicina Interna, Cardioangiologia, Epatologia, Policlinico S.Orsola-Malpighi, via Massarenti, 9, 40138 Bologna, Italy. gralex@libero.it

Telephone: +39-51-6363631 Fax: +39-51-340877

Received: December 10, 2003
Revised: March 26, 2004
Accepted: March 4, 2004
Published online: August 15, 2004

Abstract

We report a case of a 61-year-old man who presented with fatigue, abdominal pain and hepatomegaly. Computed tomography (CT) of the abdomen showed hepatomegaly and multiple hepatic lesions highly suggestive of metastatic diseases. Due to the endoscopic finding of colon ulcer, colon cancer with liver metastases was suspected. Biochemically a slight increase of transaminases, alkaline phosphatase and gammaglutamyl transpeptidase were present; α - fetoprotein, carcinoembryogenic antigen and carbohydrate 19-9 antigen serum levels were normal. Laboratory and instrumental investigations, including colon and liver biopsies revealed no signs of malignancy. In the light of spontaneous improvement of symptoms and CT findings, his personal history was revaluated revealing direct contact with pigs and their tissues. Diagnosis of leptospirosis was considered and confirmed by detection of an elevated titer of antibodies to leptospira. After two mo, biochemical data, CT and colonoscopy were totally normal.

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