A case of hepatic inflammatory pseudotumor protruding from the liver surface

Abstract

We report a case of a resected hepatic inflammatory pseudotumor (IPT) protruding from the liver surface. A 69-year-old male with diabetes mellitus was admitted to hospital for investigation of an hepatic mass. An irregularly shaped, low-echoic mass measuring 21 × 18 mm was identified by ultrasound in S6. On computed tomography, the tumor appeared to be growing extrahepatically. After contrast enhancement, the lesion showed persistent peripheral enhancement, while the central part was hypoenhanced. On T2-weighted magnetic resonance imaging (MRI), the central portion of the lesion was hyperintense compared with the periphery. EOB-enhanced MRI revealed the mass to be being hypointense in contrast to the surrounding liver parenchyma in the hepatobiliary phase. On diffusion-weighted images, the lesion was hyperintense. Percutaneous biopsy was not attempted to avoid tumor cell dissemination. The patient underwent partial hepatectomy because of suspected malignancy. Histopathological examination of the resected specimen revealed fibrotic tissue and abundant vessels in the periphery, while a massive infiltration of inflammatory cells and fewer vessels were observed in the center. The patient was finally diagnosed with hepatic IPT of the fibrohistiocytic type.

Keywords: Inflammatory pseudotumor; Liver; Protrusion.