Multiple hepatic inflammatory pseudotumours diagnosed after laparoscopic excisional biopsy

Abstract

Inflammatory pseudotumours (IPTs) may occur in almost every organ of the human body, the liver being the second most frequent organ which is affected. Inflammatory pseudotumours of the liver are rare benign lesions of unknown aetiology, which usually present as solitary liver masses of variable sizes. The differential diagnoses of malignant liver tumours are challenging and they usually require biopsies and histologic examinations. We are presenting the case of a patient with multiple hepatic lesions which mimicked liver metastases. Two percutaneous biopsies were inconclusive. The definitive diagnosis of multiple hepatic inflammatory pseudotumours was made after a laparoscopic exploration with an excisional biopsy of liver lesions and their pathologic evaluation. All lesions disappeared after several months, without any further treatments.

Keywords: Biopsy; Inflammatory pseudotumour; Liver.

[Table/Fig-1]:

Abdomino-pelvic CT scan showing multiple focal liver lesions

[Table/Fig-2]:

Liver pseudotumour features disclosing: A – solid macroscopic lesions (specimen sections); B – well circumscribed nodular growth pattern surrounded by liver parenchyma; C – spindle cells admixed with inflammatory mononuclear cells and some macrophage lipid rich cells; D –variable extensive collagenous intercellular stroma

[Table/Fig-3]:

Complete remission after 18 months on control abdomino–pelvic MRI