Inflammatory pseudotumor of the liver treated by hepatic resection: a case report

Abstract

Inflammatory pseudotumor (IPT) of the liver is rare benign tumor. When the diagnosis of IPT is established with biopsy, simple observation or conservative therapy is preferred because of the possibility of regression. But IPT is unresponsive to the conservative treatment, surgical resection should be considered. We experienced a 63-year-old male, who was suspected hepatocellular carcinoma in abdominal computed tomography (CT) and magnetic resonance image (MRI) scan, presented with 2-month history of intermittent fever and weight loss. Percutaneous ultrasound guided core biopsy confirmed IPT of the liver. Non-steroidal anti-inflammatory drugs and antibiotics were administered for 8 and 4 weeks, respectively, but fever continued. So, extended right hepatectomy was performed for IPT of the liver and then fever subsided. The patient remains well during a follow-up period of 12 months.

Fig. 1

Contrast enhanced T1 weighted MRI scan shows a relatively well-encapsulated, hypervascular mass, 6 cm in diameter on the right lobe of the liver.

Fig. 2

Percutaneous biopsy shows the marked infiltration of lymphoplasma cells and some lymphocytes that are without cytologic atypia (H&E, × 400).

Fig. 3

Three months after the initial presentation, a follow-up contrast enhanced CT scan shows no interval changes of the tumor measuring 6 × 5.5 cm in Couinaud segment VIII of the liver.

Fig. 4

The cut surface shows a yellowish-white nodule that is firm and well circumscribed.

Fig. 5

Histologic findings of the tumor reveals a mixture of chronic inflammatory cells in which the polyclonal plasma cells predominate in a background of fibrotic stroma. (H&E, × 400).