Inflammatory pseudotumors of the liver: prevalence and clinical impact in surgical patients

Abstract

Background/aims: Progress in diagnostic imaging has increased the number of focal liver lesions detected and reports of an occasional finding of inflammatory pseudotumors of the liver are becoming numerous. To estimate their prevalence and clinical impact in surgical series we evaluate retrospectively our experience.

Methodology: Four hundred and three patients carriers of a total of 717 focal liver lesions underwent liver resection consecutively in our Department from October 1995 to August 1999. All these patients underwent surgery.

Results: After surgical resection, 3 patients each proved to be carrying an IPT nodule accounting for 0.7% of all patients and 0.4% of all focal liver lesions. One inflammatory pseudotumor was only disclosed intraoperatively in a patient with an hepatocellular carcinoma. The other 2 accounted for 20% of the patients whose preoperative diagnoses were wrong. The operative procedures for the inflammatory pseudotumor nodules were: wedge resection, because the inflammatory pseudotumor was considered a new malignancy, a limited resection and a left extended hepatectomy with bilioenteric anastomosis, distal gastrectomy and lymphoadenectomy in one patient each. Inflammatory pseudotumors accounted for 33% of wrong indication for surgery.

Conclusions: Our experience shows that, despite the low prevalence of hepatic inflammatory pseudotumors, their impact in the appropriate management of patients with focal liver lesions is not irrelevant.