Solitary necrotic nodule of the liver: a very challenging diagnosis!

Solitary necrotic nodule of the liver is a rare entity of unknown aetiology. We describe the case of a 59-year-old woman reporting sporadic right upper quadrant pain. An abdominal CT scan revealed a liver nodule located in segment 4. The complementary investigation was unable to identify the neoplastic lesion, and its surgical resection was performed, with an uneventful recovery. Pathological examination revealed a 'solitary necrotic nodule of the liver.' The patient remains asymptomatic and free of recurrence 3 years after surgery. This case corroborates that despite the advances in liver imaging and biopsy, liver nodules are sometimes a diagnostic challenge; quite often, only its surgical resection allows a definitive diagnosis.