A case of leptospirosis simulating colon cancer with liver metastases

We report a case of a 61-year-old man who presentedwith fatigue,abdominal pain and hepatomegaly.Computedtomography (CT) of the abdomen showed hepatomegalyand multiple hepatic lesions highly suggestive of metastaticdiseases.Due to the endoscopic finding of colon ulcer,coloncancer with liver metastases was suspected.Biochemicallya slight increase of transaminases,alkaline phosphataseand gammaglutamyl transpeptidase were present;α-fetoprotein,carcinoembryogenic antigen and carbohydrate19-9 antigen serum levels were normal.Laboratory andinstrumental investigations,including colon and liver biopsiesrevealed no signs of malignancy.In the light of spontaneousimprovement of symptoms and CT findings,his personalhistory was revaluated revealing direct contact with pigsand their tissues.Diagnosis of leptospirosis was consideredand confirmed by detection of an elevated titer of antibodiesto leptospira.After two mo,biochemical data,CT andcolonoscopy were totally normal.