Inflammatory syndrome with liver adenomatosis: the beneficial effects of surgical management

We report a case of a patient with an inflammatory syndrome cured after resection of an adenoma. A 33-year-old woman was admitted to the department of internal medicine in May 2004 for invalidating pain in the spinal cord in the context of an inflammatory syndrome. The patient had been on oral contraceptives (Adepal) for the past 16 years. The inflammatory syndrome involved fever (37.4–38°C), anaemia, C reactive protein 90 mg/l, fibrinogen 7 g/l, sedimentation rate 106 mm and haptoblobin 2.9 g/l. Investigations for infectious, viral, systemic, hormonal and haematological disorders were all negative. Liver function tests showed abnormally high levels of alkaline phosphatase (×3N), γ-glutamyltransferase (×2N), and alanine aminotransferase (×1.5N). Liver ultrasound scan showed two nodules in the right lobe (12 and 4 cm across), which was confirmed by magnetic resonance imaging (MRI), and three additional 1-cm-nodules in the same lobe. A right …