Hepatic brucelloma: two new cases and a review of the literature

We report two new cases of hepatic brucelloma in addition to the 22 previou sly reported cases in the literature. Our analysis of these cases reveals c ertain characteristics. Hepatic brucelloma is a rape localization that foll ows previously undetected acute brucellosis. Brucelloma is a result of case ification of a granulomatous reaction induced by persistent Brucella in mac rophages. Clinical manifestations can mimic malignant liver tumors or pyoge nic, amebic liver abscess, Diagnosis is based on the association of charact eristic imaging features (central calcification and peripheral necrotic are as), positive serology and hepatic granulomas. Brucella is rarely isolated in the blood or liver Awareness of this clinical variant can prevent unnece ssary laparotomy. Treatment should begin with rifampicine (900 mg per day) and doxycyclin (200 mg per day) for 3 months. If medical treatment is unsuc cessful, percutaneous or surgical drainage should be performed. A cure shou ld be achieved in all cases.