Pleural empyema and hepatic abscess in an immunosuppresed patient with hypopharyngeal cancer

We present the case of a 64-year-old patient, diagnosed with squamous cell carcinoma of the pyriform sinus of the hypopharynx with lateral cervical lymph nodes metastases, treated with chemo- and radiotherapy, diabetic, who presented at emergency room (ER) for an altered general condition: malaise, dyspnoea on exertion and important pain in the right abdominal quadrant radiating at the scapula level. This symptomatology started few weeks ago, after chemotherapy and progressively aggravated in the last month.
The chest X-ray and the thoracic CT scan reveal the pleural effusion. The abdominal CT scan found a hepatic formation and the presence of perihepatic ascites, raising the suspicion of liver abscess. We initiated antibiotic therapy and pleural drainage with slowly improving evolution and the asymptomatic hepatic formation showed by the CT scan decreased considerably in size. The patient is transferred to the Surgical Department for percutaneous drainage of the hepatic abscess.