An unusual case of a tuberculous granuloma of the liver presenting thirteen years after intravesical BCG - therapy for bladder cancer

The authors present the case of a female patient with a tumor of the 7th liver segment, which was postoperatively identified as a tuberculous granuloma. The patient was admitted for elective surgery for a liver tumor, which had been diagnosed a few months before. Computed tomography and nuclear magnetic resonance had been performed, based on which focal nodular hyperplasia had been suspected. Thirteen years prior to admission the patient had undergone a transurethral resection of a superficial bladder carcinoma, followed by adjuvant intravesical Bacillus Calmette-Guérin (BCG- therapy). Upon surgery, the 7th segment of the liver was resected; postoperative course were uneventful. After identification of the granuloma the patient was referred to a phthysiatric clinic for further diagnostics and treatment. The authors have deemed this case worthy of reporting primarily due to the exceptionally long period between the completion of the BCG therapy and the onset of the hepatic tumor.