A single hepatic mass with two tales: hepatic tuberculosis and hepatocellular carcinoma

Hepatic tuberculosis (HTB) is an uncommon manifestation of tuberculous infections, and there has been no proven causal link between HTB and hepatocellular carcinoma (HCC). We herein present a rare case of a synchronous presentation of HTB and HCC within a single hepatic mass. A 57-year-old Chinese gentleman with recently diagnosed sigmoid adenocarcinoma was found to have a left lower lobe pulmonary nodule and solitary hepatic mass on staging computed tomography. Biopsies showed the hepatic mass to have both HTB and HCC components. This serves as a reminder that HTB is an important differential to consider for space-occupying lesions in the liver. Histological evaluation of suspected hepatic malignancies is recommended to exclude the presence of HTB in appropriate clinical settings.