Anaerobic liver abscesses as initial presentation of silent colonic cancer.

BACKGROUND: Rarely, multiple liver abscesses caused by anaerobic organisms are the presenting form of unsuspected colonic cancer in the absence of liver metastases. CASE OUTLINE: A 68-year-old man was admitted with abdominal pain, fever and chills. Imaging scans and repeated cytology yielded a diagnosis of multiple liver abscesses. Pus cultures grew Peptostreptococcus anaerobius, Bacteroides melaninogenicus and Peptostreptococcus spp. A search for the underlying cause led to the discovery of an adenocarcinoma of the sigmoid colon. After a 12-month postoperative follow-up, the patient is free of hepatic metastases. DISCUSSION: Anaerobic liver abscesses should always alert the clinician to possible silent colonic carcinoma.