Case of Disseminated Mycobacterium Avium‑Intracellulare Complex with Hepatic Cell Carcinoma and Lymhadenopathy

Abstract

The patient was a 69‑year‑old man who presented to our hospital with a hepatic tumor. He was diagnosed with multiple hepatocellular carcinomas and began chemotherapy. After the beginning of treatment, all lesions, except for hepatic S6, disappeared. Thirty‑six months after the beginning of treatment, the patient presented to our department for surgery due to an enlarged S6 tumor and underwent a partial hepatic resection. Pathological examination revealed acid-fast bacilli in the hepatocellular carcinoma tissue, and a diagnosis of hepatic mycobacterium avium-intracellulare complex（hepatic MAC）was made. The bacteria could not be detected. Eleven months after surgery, intra‑abdominal lymph node enlargement was noted, and an open lymph node biopsy was performed in our department. The clinical diagnosis of pancreatic cancer and disseminated MAC disease was made. Currently, the primary liver cancer has not recurred 21 months after surgery, and the patient is undergoing chemotherapy for pancreatic cancer for 8 months；however, no symptoms associated with MAC disease were observed. We report a rare case of disseminated MAC diagnosed using surgical resection without immunodeficiency or pulmonary involvement.