Background: Hepatitis B and Hepatitis C are prevalent in Taiwan. Patients with chronic hepatitis have high risk of progressing to liver cirrhosis and hepato-cellular carcinoma (HCC). However, HCC associated with liver abscess is very rare.
Aim: Accordingly, we wished to analyze the characteristics of ultrasonography (US) between these patients diagnosed as liver abscess and attempt to make a differential diagnosis with HCC.
Methods: From January 2005 through July 2007, we retrospectively reviewed a total of 9 patients of HCC with abscess formation at the Kaohsiung Medical University Hospital (Kaohsiung, Taiwan). Their images with ultrasonography were analyzed.
Results: The imaging studies with abdominal ultrasonography show low-echoic liver tumors with irregular margin. Liver cirrhosis background was not revealed in 8 patients(8/9). HCC with central necrosis and liver abscess cannot be differential diagnosis definitely from the 2D sonography.
Conclusions: Inflammatory liver changes may mimic solid neoplasms. It is difficult to make an accurate differential diagnosis clinically, especially in cases of HCC with abscess. The final diagnosis usually depends on aspiration and pathology, especially the patients with liver cirrhosis diagnosis.

Keywords: hepatocellular carcinoma, liver abscess, abdominal sonography.