Hepatitis B-associated cirrhosis combined with multiple nodular fatty infiltrates of the liver: A rare benign disease misdiagnosed as hepatocellular carcinoma – a case report

Rationale: Chronic hepatitis B virus infection, if not treated with standard therapies, usually progresses to cirrhosis, which is a major risk factor for hepatocellular carcinoma (HCC). Steatosis can lead to fatty liver disease; if hepatic fatty infiltration shows multinodular changes, it is called hepatic multinodular fatty infiltration (MNFIL). However, this pattern of fatty infiltration is rare. Cirrhosis combined with MNFIL is very rare and easily misdiagnosed as HCC. Patient concerns: The patient was a 70-year-old woman with a 22-year history of hepatitis B. Physical examination revealed multiple masses in the liver. After admission, the computed tomography, ultrasound examination, and hepatic angiography findings were inconsistent. Diagnoses: Hepatitis B-associated cirrhosis combined with multiple nodular fatty liver infiltrates. Interventions: The patient ultimately underwent a partial resection of the liver mass. Outcomes: The patient was followed-up for 5 months and is currently doing well. Lessons: The appearance of multiple nodules against the background of cirrhosis does not necessarily indicate malignant nodules. If this awareness is considered during the diagnostic process, misdiagnoses can be avoided.