Ultrasound diagnosis of appendiceal tumor with synchronous liver metastasis mimicking acute appendicitis and liver abscess

Appendiceal tumors (AT) are rare gastrointestinal cancers with high incidence of synchronous and metachronous colorectal cancer metastases. AT are rarely associated with hepatic metastases. Sometimes, metastases are the first evidence of the tumor. We report the clinical, surgical and imaging records of a female patient, 81 years old, admitted for a suspect liver abscess, only subsequently diagnosed as metastasis from an undiagnosed AT. Ultrasound (US) based imaging techniques, such as Color-Doppler Ultrasound, Contrast enhanced US, US-guided biopsy of the hepatic nodule played an important role in the assessment of the definitive diagnosis.