Approach to hepatic masses Quiz: Ace Your Exams
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A 37-year-old man presents to the emergency department with a fever and dull right upper quadrant pain for the past week. Two months ago, he returned from a vacation in Mexico. He has no significant past medical or surgical history. He does not take any medication and has not been exposed to any sick contacts. Temperature is 38°C (100.4°F), heart rate is 86/min, blood pressure is 124/80 mmHg, and respiratory rate is 12/min. Physical examination shows tenderness to palpation in the right upper quadrant and hepatomegaly. Laboratory studies are shown below. An abdominal CT shows a single round mass with an enhancing solid rim and central complex fluid. Which of the following is the most likely diagnosis?
| Laboratory Value | Result | Reference Range |
| White Blood Cells | 12x103/mm3 | 4.5-11x103/mm3 |
| Neutrophils | 40% | 40% |
| Hemoglobin | 14.0 g/dL | 13.5-17.5 g/dL |
| Hematocrit | 42% | 41-53% |
| Platelets | 350x103/µL | 150-400x103/µL |
| Aspartate aminotransferase | 110 U/L | 8-40 U/L |
| Alanine aminotransferase | 105 U/L | 8-40 U/L |
| Alkaline Phosphatase | 100 U/L | 20-70 U/L |
| Bilirubin | 1.1 mg/dL | 0.1-1 mg/dL |
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