Primary hepatic actinomycosis mimicking malign liver tumor

Purpose: A 51 years old man was suffering from abdominal pain, poorly regulated diabetes and elevated infection markers (C-reactive protein (CRP) 140 mg/l) for a period of several months. In 1996 he underwent pancreaticoduodenectomy for chronic pancreatitis and a resection of liver segment V after hepaticolithiasis. In 2008, operative main bile duct revision was necessary because of stenosis of the anastomosis. Insulin dependent diabetes mellitus developed after the initial pancreatectomy. A relapse of hepaticolithiasis was proposed. MRI showed a huge tumor (9 × 5x5.5 cm) in liver segment I without lymph nodes o…