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Inflammatory fibroid polyp of the ileum presenting as intussusception and obstruction

Alb: 1.6g/dL, WBC: 13.2 K/m, HGB: 16.1gm/dL, PLT: 241 K/m, CD4 count: 557, HBsAg: reactive, HBsAb: nonreactive, HBcAb: reactive. Ultrasound revealed ascites with an enlarged, nodular, markedly heterogeneous liver without distinct masses. CT of the head showed a necrotic soft tissue mass, measuring 6 cm by 3.5 cm, surrounding the right ramus of the mandible and causing bone destruction. Due to progressive leukocytosis, biopsy of the mass was attained to differentiate between abscess and malignancy. This showed metastatic hepatocellular carcinoma. See figure below. The patient’s hospital course was complicated by sepsis with pneumonia and the patient expired. Autopsy revealed hepatocellular carcinoma with massive and multifocal involving the liver, lungs, ribs and right mandible.